Provider Demographics
NPI:1184060626
Name:NOUVELLE CARE SERVICES INC
Entity type:Organization
Organization Name:NOUVELLE CARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DIDACUS
Authorized Official - Middle Name:
Authorized Official - Last Name:UDEOJI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-376-4663
Mailing Address - Street 1:6633 W BURLEIGH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53210-1318
Mailing Address - Country:US
Mailing Address - Phone:414-376-4663
Mailing Address - Fax:
Practice Address - Street 1:6951 N 77TH CT
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53223-4903
Practice Address - Country:US
Practice Address - Phone:414-376-4663
Practice Address - Fax:414-376-4663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-10
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI0013796311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home