Provider Demographics
NPI:1720362551
Name:STRESS FREE SUPPORTIVE CARE LLC
Entity type:Organization
Organization Name:STRESS FREE SUPPORTIVE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:K
Authorized Official - Last Name:NABORS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-578-7776
Mailing Address - Street 1:10502 W HAMPTON AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53225-3911
Mailing Address - Country:US
Mailing Address - Phone:414-578-7776
Mailing Address - Fax:
Practice Address - Street 1:6041 W PORT AVE
Practice Address - Street 2:UNIT 104D
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53223-4124
Practice Address - Country:US
Practice Address - Phone:414-578-7776
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-28
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care