Provider Demographics
NPI:1104946581
Name:SAI HOME HEALTH CARE INC
Entity type:Organization
Organization Name:SAI HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF HOME CARE SERVICES
Authorized Official - Prefix:MS
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RUMACHIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-637-9128
Mailing Address - Street 1:5200 WASHINGTON AVE
Mailing Address - Street 2:SUITE 227
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53406-4238
Mailing Address - Country:US
Mailing Address - Phone:262-632-5886
Mailing Address - Fax:262-632-0074
Practice Address - Street 1:5200 WASHINGTON AVE
Practice Address - Street 2:SUITE 227
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53406-4238
Practice Address - Country:US
Practice Address - Phone:262-632-5886
Practice Address - Fax:262-632-0074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI305251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI305OtherWISCONSIN STATE LICENSE
WI43107700Medicaid
WI43107700Medicaid