Organization
PROVISIONS HEALTHCARE LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATIE ANIBAS (PRESIDENT)
(715) 450-3391
Entity
Organization
Contact information
Practice address
E2535 CEDAR RD, ELEVA, WI 54738-9083
(715) 450-3391
Mailing address
E2535 CEDAR RD, ELEVA, WI 54738-9083
(715) 450-3391
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
—
—
251E00000X
Home Health Agency
Primary
—
—
251F00000X
Home Infusion Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
03/23/2015
Last updated
03/23/2015
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