Organization
INDIVIDUAL CARE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROY MILBURN PROFITT IV (MEMBER)
(920) 296-6556
Entity
Organization
Contact information
Practice address
133 HASKELL ST, BEAVER DAM, WI 53916-1609
(920) 296-6556
Mailing address
133 HASKELL ST, BEAVER DAM, WI 53916-1609
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
06/26/2015
Last updated
06/26/2015
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