Organization
MAKING A DIFFERENCE COMMUNITY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LISA P HUNTER (CEO/FOUNDER)
(262) 344-3691
Entity
Organization
Contact information
Practice address
5902 5TH AVE, 1, KENOSHA, WI 53140-4221
(262) 577-5776
(186) 683-4169
Mailing address
PO BOX 1264, KENOSHA, WI 53141-1264
(262) 577-5776
(186) 683-4169
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
08/18/2014
Last updated
12/21/2014
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