Organization
PASOUA HOME CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PA SOUA VUE (OWNER/ADMINISTRATOR/RN)
(715) 212-7703
Entity
Organization
Contact information
Practice address
508 W WISCONSIN AVE, SUITE B, APPLETON, WI 54911-4337
(920) 358-7902
Mailing address
508 W WISCONSIN AVE, SUITE B, APPLETON, WI 54911-4337
(920) 358-7902
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100037071
—
WI
Enumeration date
01/25/2016
Last updated
01/25/2016
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