Provider Demographics
NPI:1245011758
Name:BOTTOMLINE PERSONAL CARE SERVICES
Entity type:Organization
Organization Name:BOTTOMLINE PERSONAL CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-702-2729
Mailing Address - Street 1:6222 W CAPITOL DR # 205
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53216-2154
Mailing Address - Country:US
Mailing Address - Phone:414-885-1010
Mailing Address - Fax:414-885-2003
Practice Address - Street 1:6222 W CAPITOL DR # 205
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53216-2154
Practice Address - Country:US
Practice Address - Phone:414-885-1010
Practice Address - Fax:414-885-2003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care