Provider Demographics
NPI:1194287557
Name:BUSALACCHI ENTERPRISES INCORPORATED
Entity type:Organization
Organization Name:BUSALACCHI ENTERPRISES INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:BUSALACCHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-736-8368
Mailing Address - Street 1:4810 S 76TH ST STE 102
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53220-4300
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4810 S 76TH ST STE 102
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:WI
Practice Address - Zip Code:53220-4300
Practice Address - Country:US
Practice Address - Phone:414-763-8368
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-04
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care