Individual provider · Type 1 NPI
Jodi Ann Buckett Vanwormer
Adult Care Home Facility · Elkhorn, WI
NPI number
1780411983
Active
Practice location
W3928 Potter Rd
Elkhorn, WI 53121-4041
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Care Home Facility Primary | 311ZA0620X | 0010620 (WI) |
Adult Care Home Facility: A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.
About NPI 1780411983
Jodi Ann Buckett Vanwormer's National Provider Identifier is 1780411983, issued on Sep 19, 2024. The primary taxonomy on file is Adult Care Home Facility (311ZA0620X), and the practice location is in Elkhorn, WI. The record was last updated on Sep 19, 2024.