Advanced Living Care LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

ADVANCED LIVING CARE LLC

Practice address

903 Bongey Dr
Menomonie, WI 54751-3780

Phone

(715) 505-2812

Fax

(855) 486-9323

NPI assigned

Feb 23, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lee Yang

Title

Administrator

Phone

(715) 505-2812

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1456185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456185600000",
    "number": "1306205067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 BONGEY DR",
            "city": "MENOMONIE",
            "state": "WI",
            "postal_code": "547513780",
            "telephone_number": "715-505-2812",
            "fax_number": "855-486-9323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 BONGEY DR",
            "city": "MENOMONIE",
            "state": "WI",
            "postal_code": "547513780",
            "telephone_number": "715-505-2812",
            "fax_number": "855-486-9323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED LIVING CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-23",
        "last_updated": "2016-02-23",
        "status": "A",
        "authorized_official_last_name": "YANG",
        "authorized_official_first_name": "LEE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "715-505-2812"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100027125",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• In Home Supportive Care Agency in Menomonie, WI
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.