Organization
INDIVIDUALIZED CARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ROSE MARY BENSON-SPANG (OWNER)
19202697201
Entity
Organization
Contact information
Practice address
N7282 WATERCRESS LN, BEAVER DAM, WI 53916
(920) 356-0878
(920) 356-0878
Mailing address
N7282 WATERCRESS LN, BEAVER DAM, WI 53916
(920) 356-0878
(920) 356-0878
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
08/25/2008
Last updated
08/25/2008
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