Provider Demographics
NPI:1881067411
Name:TOGETHER AT HOME PERSONAL CARE AGENCY LLC
Entity type:Organization
Organization Name:TOGETHER AT HOME PERSONAL CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:TRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMBLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-353-9199
Mailing Address - Street 1:301 BARBIE DR
Mailing Address - Street 2:
Mailing Address - City:WEST BEND
Mailing Address - State:WI
Mailing Address - Zip Code:53090-1128
Mailing Address - Country:US
Mailing Address - Phone:262-353-9199
Mailing Address - Fax:888-965-4099
Practice Address - Street 1:301 BARBIE DR
Practice Address - Street 2:
Practice Address - City:WEST BEND
Practice Address - State:WI
Practice Address - Zip Code:53090-1128
Practice Address - Country:US
Practice Address - Phone:262-353-9199
Practice Address - Fax:888-965-4099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-04
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100040733Medicaid