Organization
PETRA'S LIVING ASSISTANCE, LLC
Active
Other names
Visiting Angels
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT STOLLENWERK (CEO)
(262) 695-4418
Entity
Organization
Contact information
Practice address
347 PARK AVE, PEWAUKEE, WI 53072-3413
(262) 695-4418
(262) 695-7461
Mailing address
347 PARK AVE, PEWAUKEE, WI 53072-3413
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
09/26/2016
Last updated
09/26/2016
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