Organization
SUPPORTIVE LIVING HOME HEALTH CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ANDERSON RN (RN ADMINISTRATOR)
(414) 484-6037
Entity
Organization
Contact information
Practice address
6815 W CAPITOL DR, SUITE 212, MILWAUKEE, WI 53216-2070
(414) 484-6037
(414) 755-7450
Mailing address
6815 W CAPITOL DR, SUITE 212, MILWAUKEE, WI 53216-2070
(414) 484-6037
(414) 755-7450
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100042529
—
WI
Enumeration date
05/11/2017
Last updated
05/11/2017
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