Organization
PURE SUPPORT LLC
Active
Other names
Pure Support
Organization subpart
No
Provider details
NPI number
Authorized official
MITCHELL SHERMAN CPS (MEMBER, MANAGER, FOUNDER)
(262) 203-0247
Entity
Organization
Contact information
Practice address
3770 COUNTY ROAD F N, DELAVAN, WI 53115-2963
(262) 203-0247
Mailing address
3770 COUNTY ROAD F N, DELAVAN, WI 53115-2963
(262) 203-0247
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
—
—
172V00000X
Community Health Worker
—
—
174400000X
Specialist
—
—
175T00000X
Peer Specialist
Primary
—
—
225400000X
Rehabilitation Practitioner
—
—
225800000X
Recreation Therapist
—
—
372600000X
Adult Companion
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
374J00000X
Doula
—
—
374K00000X
Religious Nonmedical Practitioner
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
405300000X
Prevention Professional
—
—
Other
Enumeration date
11/11/2022
Last updated
12/16/2022
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