Provider Demographics
NPI:1134451230
Name:AMBER HOUSE INC.
Entity type:Organization
Organization Name:AMBER HOUSE INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:VIVIAN
Authorized Official - Middle Name:JULIET
Authorized Official - Last Name:ST. JULIEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-379-3636
Mailing Address - Street 1:7414 W HAMPTON AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53218-4746
Mailing Address - Country:US
Mailing Address - Phone:414-393-9922
Mailing Address - Fax:414-393-9923
Practice Address - Street 1:7414 W HAMPTON AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53218-4746
Practice Address - Country:US
Practice Address - Phone:414-393-9922
Practice Address - Fax:414-393-9923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-01
Last Update Date:2010-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health