Organization
WICIS INC
Active
Other names
wicishealth
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LILIANA CARLOTA FENES I (VP OF SALES)
(510) 289-2929
Entity
Organization
Contact information
Practice address
111 W PROCTOR ST, CARSON CITY, NV 89703-4133
(510) 289-2929
Mailing address
111 W PROCTOR ST, CARSON CITY, NV 89703-4133
(510) 289-2929
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B9819859
DRIVER LICENSE
CA
Enumeration date
05/31/2019
Last updated
06/11/2019
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