Provider Demographics
NPI:1801572920
Name:YOUNG VISIONS HOME CARE SERVICES LLC
Entity type:Organization
Organization Name:YOUNG VISIONS HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LA SHANDRA
Authorized Official - Middle Name:NICHELLE
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:414-914-9339
Mailing Address - Street 1:PO BOX 76068
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53216-7668
Mailing Address - Country:US
Mailing Address - Phone:414-914-9339
Mailing Address - Fax:414-914-9239
Practice Address - Street 1:3115 N 5TH STREET
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53212
Practice Address - Country:US
Practice Address - Phone:414-914-9339
Practice Address - Fax:414-914-9239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-23
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care