NPIMap

Organization Active NPI

Professional Personal Care Servcies

  • In Home Supportive Care Agency
  • Glendale, WI
National Provider Identifier
1215316088
Registry record updated May 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
10043014 Issued in WI
Legal business name
PROFESSIONAL PERSONAL CARE SERVCIES
Practice address
500 W Silver Spring Dr
Suite 200
Glendale, WI 53217-5051
Phone
(414) 847-6331
Fax
(414) 435-3152
NPI assigned
May 26, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Twanda Gates, RN
Title
Administrator
Phone
(414) 847-6330

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X 10043014 WI Primary

Addresses

Primary practice location

500 W Silver Spring Dr
Suite 200
Glendale, WI 53217-5051

Mailing address

500 W Silver Spring Dr
Suite 200
Glendale, WI 53217-5051
Phone (414) 847-6331

Other identifiers 1

IdentifierTypeStateIssuer
100043014MedicaidWI

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1432598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432598400000",
    "number": "1215316088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W SILVER SPRING DR",
            "address_2": "SUITE 200",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532175051",
            "telephone_number": "414-847-6331",
            "fax_number": "414-435-3152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W SILVER SPRING DR",
            "address_2": "SUITE 200",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532175051",
            "telephone_number": "414-847-6331",
            "fax_number": "414-435-3152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL PERSONAL CARE SERVCIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-26",
        "last_updated": "2015-05-26",
        "status": "A",
        "authorized_official_last_name": "GATES",
        "authorized_official_first_name": "TWANDA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "414-847-6330",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "WI",
            "license": "10043014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100043014",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.