NPIMap

Organization Active NPI

Humble Living Home Two

  • Case Management Agency
  • West Bend, WI
National Provider Identifier
1295446912
Registry record updated Dec 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
HUMBLE LIVING HOME TWO
Practice address
923 Tower LN
West Bend, WI 53090-2425
Phone
(262) 239-1138
NPI assigned
Dec 13, 2022
Organization subpart
Yes
Parent organization
HUMBLE LIVING ADULT FAMILY GROUP HOME LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 13, 2022

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

Authorized official

Name
Vershaunda Campbell
Title
Owner
Phone
(262) 239-1138

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

923 Tower LN
West Bend, WI 53090-2425

Mailing address

923 Tower LN
West Bend, WI 53090-2425

Other practice location 1

925 Tower Ln
West Bend, WI 53090-2425
Phone (262) 239-1138

National Provider Directory

National Provider Directory
Part of
Humble Living Adult Family Group Home LLC

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1670889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670889600000",
    "number": "1295446912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "923 TOWER LN",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530902425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "923 TOWER LN",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530902425",
            "telephone_number": "262-239-1138"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "925 Tower Ln",
            "address_purpose": "LOCATION",
            "city": "West Bend",
            "state": "WI",
            "postal_code": "530902425",
            "country_code": "US",
            "telephone_number": "262-239-1138",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HUMBLE LIVING HOME TWO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HUMBLE LIVING ADULT FAMILY GROUP HOME LLC",
        "enumeration_date": "2022-12-13",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "VERSHAUNDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-239-1138"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bend, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2022; 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.