Organization Active NPI

Easy Living Home Health Care Agency, Inc.

  • Home Health Agency
  • Germantown, WI
National Provider Identifier
1609195239
Registry record updated Jun 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
EASY LIVING HOME HEALTH CARE AGENCY, INC.
Practice address
W175N11117 Stonewood Dr Ste 100
Germantown, WI 53022-6505
Phone
(262) 293-3951
Fax
(262) 345-5162
NPI assigned
May 21, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2016

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

Authorized official

Name
Laura Balcerak, COTA
Title
Co Owner
Phone
(262) 293-3951

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

W175N11117 Stonewood Dr Ste 100
Germantown, WI 53022-6505

Mailing address

W175N11117 Stonewood Dr Ste 100
Germantown, WI 53022-6505
Phone (262) 293-3951

Other identifiers 1

IdentifierTypeStateIssuer
52-7313OtherWIPTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory

Locations

W175N11117 Stonewood Dr
Ste 100
Germantown, WI 53022
Phone (262) 227-8196

703 Fremont St
Kiel, WI 53042
Phone (920) 827-4555

230 W Cook St
Portage, WI 53901
Phone (262) 293-3951

Ownership & related parties

Change-of-ownership history 1

DateEventCounterparty
Jun 1, 2019 Change of OwnershipThis provider was the seller Preceptor Home HealthCCN 527313, WI, NPI 1255996740

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1274400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464739200000",
    "number": "1609195239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W175N11117 STONEWOOD DR STE 100",
            "city": "GERMANTOWN",
            "state": "WI",
            "postal_code": "530226505",
            "telephone_number": "262-293-3951",
            "fax_number": "262-345-5162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W175N11117 STONEWOOD DR STE 100",
            "city": "GERMANTOWN",
            "state": "WI",
            "postal_code": "530226505",
            "telephone_number": "262-293-3951",
            "fax_number": "262-345-5162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASY LIVING HOME HEALTH CARE AGENCY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-21",
        "last_updated": "2016-06-01",
        "status": "A",
        "authorized_official_last_name": "BALCERAK",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "CO OWNER",
        "authorized_official_telephone_number": "262-293-3951",
        "authorized_official_credential": "COTA"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "52-7313",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, WI

Sources for this page

Verify at the official NPI Registry.