Provider Demographics
NPI:1699131151
Name:FULL HOME HEALTH SERVICES LLC
Entity type:Organization
Organization Name:FULL HOME HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:ABIMBOLA
Authorized Official - Middle Name:S
Authorized Official - Last Name:BLAGOGEE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:608-237-3550
Mailing Address - Street 1:1320 MENDOTA STREET
Mailing Address - Street 2:SUITE 110
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53714
Mailing Address - Country:US
Mailing Address - Phone:608-237-3550
Mailing Address - Fax:608-819-6433
Practice Address - Street 1:1320 MENDOTA ST
Practice Address - Street 2:SUITE 110
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53714-1096
Practice Address - Country:US
Practice Address - Phone:608-237-3550
Practice Address - Fax:608-819-6433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-13
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health