Organization
MIDWEST FAMILY SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALSHILOH SHALISHA JOHNSON (OWNER)
(773) 990-9833
Entity
Organization
Contact information
Practice address
1717 24TH ST, KENOSHA, WI 53140-1847
(773) 990-9833
Mailing address
1717 24TH ST, KENOSHA, WI 53140-1847
(773) 990-9833
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Enumeration date
01/19/2024
Last updated
05/05/2026
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