Provider Demographics
NPI:1063297273
Name:WENGLIKOWSKI HEALTHCARE SERVICES, LLC
Entity type:Organization
Organization Name:WENGLIKOWSKI HEALTHCARE SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WENGLIKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:281-202-4789
Mailing Address - Street 1:3421 W DAVIS ST STE 220
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-1846
Mailing Address - Country:US
Mailing Address - Phone:936-600-5552
Mailing Address - Fax:
Practice Address - Street 1:3421 W DAVIS ST STE 220
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-1846
Practice Address - Country:US
Practice Address - Phone:936-600-5552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-28
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health