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Organization

PLEASANTVILLE HOME CARE AGENCY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KEITH MARTIN JR. (PRESIDENT)
(414) 759-6059
Entity
Organization

Contact information

Practice address
4200 N HOLTON ST STE 100, MILWAUKEE, WI 53212-1064
(414) 909-0296
(414) 962-4003
Mailing address
4200 N HOLTON ST STE 100, MILWAUKEE, WI 53212-1064
(414) 909-0296
(414) 962-4003

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary

Other

Enumeration date
04/25/2019
Last updated
04/25/2019
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