Provider Demographics
NPI:1487959490
Name:IN-HOME CARE OF WISCONSIN, INC.
Entity type:Organization
Organization Name:IN-HOME CARE OF WISCONSIN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:YANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-203-1337
Mailing Address - Street 1:611 N LYNNDALE DR
Mailing Address - Street 2:125
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54914-3041
Mailing Address - Country:US
Mailing Address - Phone:715-203-1337
Mailing Address - Fax:800-839-7065
Practice Address - Street 1:611 N LYNNDALE DR
Practice Address - Street 2:125
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54914-3041
Practice Address - Country:US
Practice Address - Phone:715-203-1337
Practice Address - Fax:800-839-7065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-21
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care