Provider Demographics
NPI:1649847294
Name:HEALING HANDS ADULT FAMILY HOMES
Entity type:Organization
Organization Name:HEALING HANDS ADULT FAMILY HOMES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:0WNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHELBY
Authorized Official - Middle Name:J
Authorized Official - Last Name:BREMER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:608-906-4343
Mailing Address - Street 1:1173 OKEEFFE AVE
Mailing Address - Street 2:
Mailing Address - City:SUN PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53590-4236
Mailing Address - Country:US
Mailing Address - Phone:608-906-4343
Mailing Address - Fax:
Practice Address - Street 1:6652 N TOWNE RD APT 121
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:WI
Practice Address - Zip Code:53598-9130
Practice Address - Country:US
Practice Address - Phone:608-906-4343
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-10
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty