Provider Demographics
NPI:1730332321
Name:4U ADULT DAY SERVICE, LLC
Entity type:Organization
Organization Name:4U ADULT DAY SERVICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:SWOP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-544-4154
Mailing Address - Street 1:2311 POST RD
Mailing Address - Street 2:
Mailing Address - City:PLOVER
Mailing Address - State:WI
Mailing Address - Zip Code:54467-2972
Mailing Address - Country:US
Mailing Address - Phone:715-544-4154
Mailing Address - Fax:715-544-4180
Practice Address - Street 1:2311 POST RD
Practice Address - Street 2:
Practice Address - City:PLOVER
Practice Address - State:WI
Practice Address - Zip Code:54467-2972
Practice Address - Country:US
Practice Address - Phone:715-544-4154
Practice Address - Fax:715-544-4180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child