Provider Demographics
NPI:1467281667
Name:ROBERT LEE AT EASE SERVICES LLC
Entity type:Organization
Organization Name:ROBERT LEE AT EASE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LATOYA
Authorized Official - Middle Name:MONIQUE
Authorized Official - Last Name:SPENCER
Authorized Official - Suffix:
Authorized Official - Credentials:AAS
Authorized Official - Phone:470-880-7858
Mailing Address - Street 1:3500 N SHERMAN BLVD STE 305A
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53216-3463
Mailing Address - Country:US
Mailing Address - Phone:414-455-7471
Mailing Address - Fax:207-419-7426
Practice Address - Street 1:3500 N SHERMAN BLVD STE 305A
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53216-3463
Practice Address - Country:US
Practice Address - Phone:414-455-7471
Practice Address - Fax:207-419-7426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-29
Last Update Date:2025-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health