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Organization
PERSONAL CARE PLUS AGENCY
Active
Organization
PERSONAL CARE PLUS AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KYMNESHIA BRYAN (ADMININSTRATOR)
(414) 259-1573
Entity
Organization
Contact information
Practice address
1370 S 74TH ST STE 102, WEST ALLIS, WI 53214-3059
(414) 259-1573
(877) 803-7696
Mailing address
1370 S 74TH ST STE 102, WEST ALLIS, WI 53214-3059
(414) 259-1573
(877) 803-7696
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100086649
—
WI
Enumeration date
05/15/2019
Last updated
05/15/2019
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