Provider Demographics
NPI:1154394005
Name:VISITING NURSE COMMUNITY CARE, INC.
Entity type:Organization
Organization Name:VISITING NURSE COMMUNITY CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:JENE
Authorized Official - Last Name:HERTZBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-656-8400
Mailing Address - Street 1:600 52ND ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53140-3423
Mailing Address - Country:US
Mailing Address - Phone:262-656-8400
Mailing Address - Fax:262-656-8406
Practice Address - Street 1:600 52ND ST
Practice Address - Street 2:SUITE 300
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53140-3423
Practice Address - Country:US
Practice Address - Phone:262-656-8400
Practice Address - Fax:262-656-8406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL391310Medicare ID - Type UnspecifiedWPS