Provider Demographics
NPI:1285324459
Name:AAH OF WISCONSIN I, LLC
Entity type:Organization
Organization Name:AAH OF WISCONSIN I, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SVP, CHIEF LEGAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:
Authorized Official - Last Name:ADKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-309-5668
Mailing Address - Street 1:10 CADILLAC DR STE 400
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-1001
Mailing Address - Country:US
Mailing Address - Phone:615-637-9163
Mailing Address - Fax:615-373-4457
Practice Address - Street 1:134 W COLUMBIA ST STE 2
Practice Address - Street 2:
Practice Address - City:CHIPPEWA FALLS
Practice Address - State:WI
Practice Address - Zip Code:54729-2347
Practice Address - Country:US
Practice Address - Phone:715-861-8353
Practice Address - Fax:715-203-0273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-11
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based