Organization
SUPPORTIVE PERSONAL CARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WANDA STAPLES (OWNER)
(414) 365-9108
Entity
Organization
Contact information
Practice address
2025 N SUMMIT AVE STE 103, MILWAUKEE, WI 53202-1362
(414) 365-9108
(414) 355-5585
Mailing address
2025 N SUMMIT AVE STE 103, MILWAUKEE, WI 53202-1362
(414) 365-9108
(414) 369-3686
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100028490
—
WI
Enumeration date
09/25/2013
Last updated
04/09/2024
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