Organization
MASIREY HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MUSTAPHA KAMBI (OWNER/PRESIDENT)
(231) 343-8538
Entity
Organization
Contact information
Practice address
213 W COTTAGE GROVE RD STE G9, COTTAGE GROVE, WI 53527-9327
(231) 343-8538
Mailing address
213 W COTTAGE GROVE RD STE G6, COTTAGE GROVE, WI 53527-9327
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
10/17/2018
Last updated
09/13/2019
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