# SUPPORTIVE PERSONAL CARE SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568898260
- **Authorized official:** WANDA STAPLES (OWNER)
- **Authorized official phone:** (414) 365-9108

## Contact information

- **Practice address:** 2025 N SUMMIT AVE STE 103, MILWAUKEE, WI 53202-1362
- **Practice address phone:** (414) 365-9108
- **Practice address fax:** (414) 355-5585
- **Mailing address:** 2025 N SUMMIT AVE STE 103, MILWAUKEE, WI 53202-1362
- **Mailing address phone:** (414) 365-9108
- **Mailing address fax:** (414) 369-3686

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 09/25/2013
- **Last updated:** 04/09/2024