Organization
ADVANCED LIVING CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEE YANG (ADMINISTRATOR)
(715) 505-2812
Entity
Organization
Contact information
Practice address
903 BONGEY DR, MENOMONIE, WI 54751-3780
(715) 505-2812
(855) 486-9323
Mailing address
903 BONGEY DR, MENOMONIE, WI 54751-3780
(715) 505-2812
(855) 486-9323
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100027125
—
WI
Enumeration date
02/23/2016
Last updated
02/23/2016
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