Organization
MY HOME SWEET HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA CLARK (OWNER)
(786) 298-3692
Entity
Organization
Contact information
Practice address
209 BRANDON ST, WAUPUN, WI 53963-1303
(786) 298-3692
Mailing address
209 BRANDON ST, WAUPUN, WI 53963-1303
(862) 983-6927
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
10/15/2021
Last updated
10/15/2021
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