Organization
LIVING INSIGHT SUPPORTIVE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELIA BLACK (ADMINISTRATOR)
(262) 689-0028
Entity
Organization
Contact information
Practice address
3065 N 124TH ST STE 203, BROOKFIELD, WI 53005-3874
(262) 794-3374
(262) 794-3274
Mailing address
3065 N 124TH ST STE 203, BROOKFIELD, WI 53005-3874
(262) 794-3374
(262) 794-3274
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
105058-30
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100070961
—
WI
Enumeration date
10/09/2017
Last updated
12/22/2021
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