Provider Demographics
NPI:1265780969
Name:COURTEOUS HOME HEALTH CARE
Entity type:Organization
Organization Name:COURTEOUS HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LATONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLOWAY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:414-241-6855
Mailing Address - Street 1:4550 S NICHOLSON AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:CUDAHY
Mailing Address - State:WI
Mailing Address - Zip Code:53110-1365
Mailing Address - Country:US
Mailing Address - Phone:414-241-6855
Mailing Address - Fax:
Practice Address - Street 1:4550 S NICHOLSON AVE
Practice Address - Street 2:APT 2
Practice Address - City:CUDAHY
Practice Address - State:WI
Practice Address - Zip Code:53110-1361
Practice Address - Country:US
Practice Address - Phone:414-241-6855
Practice Address - Fax:414-241-9855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-28
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health