1770012056 NPI number — STRONG HOME CARE AND COMPANIONS

Table of content: (NPI 1770012056)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770012056 NPI number — STRONG HOME CARE AND COMPANIONS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STRONG HOME CARE AND COMPANIONS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1770012056
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6110 N PORT WASHINGTON RD STE 3
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GLENDALE
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
53217-4308
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
414-507-9501
Provider Business Mailing Address Fax Number:
781-810-9584

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6110 N PORT WASHINGTON RD
Provider Second Line Business Practice Location Address:
SUITE 3
Provider Business Practice Location Address City Name:
GLENDALE
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53217
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
414-507-9501
Provider Business Practice Location Address Fax Number:
781-810-9584
Provider Enumeration Date:
06/08/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
STRONG-BELCHER
Authorized Official First Name:
LESLEY
Authorized Official Middle Name:
NICOLE
Authorized Official Title or Position:
ADMINSTRATOR
Authorized Official Telephone Number:
414-507-9501

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 100067169 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".