Provider Demographics
NPI:1780167775
Name:COUNTRY CARES LLC
Entity type:Organization
Organization Name:COUNTRY CARES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:KASPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-597-0033
Mailing Address - Street 1:W8172 COUNTY ROAD B
Mailing Address - Street 2:
Mailing Address - City:LAKE MILLS
Mailing Address - State:WI
Mailing Address - Zip Code:53551-9727
Mailing Address - Country:US
Mailing Address - Phone:920-597-0033
Mailing Address - Fax:608-423-3616
Practice Address - Street 1:W8172 COUNTY ROAD B
Practice Address - Street 2:
Practice Address - City:LAKE MILLS
Practice Address - State:WI
Practice Address - Zip Code:53551-9727
Practice Address - Country:US
Practice Address - Phone:920-597-0033
Practice Address - Fax:608-423-3616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-14
Last Update Date:2018-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health