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Organization
TABOMA CORPORATION
Active
Organization
TABOMA CORPORATION
Active
Other names
BrightStar Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACK LOUKS (PRESIDENT)
(262) 637-7767
Entity
Organization
Contact information
Practice address
4701 WASHINGTON AVE, SUITE 290, RACINE, WI 53406-4232
(262) 637-7767
(262) 637-7764
Mailing address
4701 WASHINGTON AVE, SUITE 290, RACINE, WI 53406-4232
(262) 637-7767
(262) 637-7764
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
1082
WI
251J00000X
Nursing Care Agency
1082
WI
Other
Enumeration date
12/11/2007
Last updated
12/11/2007
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