Organization
LACROSSE HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAYIA HER (OWNER)
(608) 519-2914
Entity
Organization
Contact information
Practice address
1702 GEORGE ST, LA CROSSE, WI 54603-2150
(608) 519-2914
(608) 519-2915
Mailing address
1702 GEORGE ST, LA CROSSE, WI 54603-2150
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100042433
—
WI
Enumeration date
12/08/2015
Last updated
12/08/2015
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