Wisconsin Independent Living Solutions LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

WISCONSIN INDEPENDENT LIVING SOLUTIONS LLC

Practice address

817 Colton St
Waukesha, WI 53186-5126

Phone

(262) 402-7496

NPI assigned

Oct 28, 2020

Organization subpart

No

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

Authorized official

Name

Brandon Weidner

Title

Owner

Phone

(262) 402-7496

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1603843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603843200000",
    "number": "1639779754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 COLTON ST",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531865126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 COLTON ST",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531865126",
            "telephone_number": "262-402-7496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISCONSIN INDEPENDENT LIVING SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-28",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A",
        "authorized_official_last_name": "WEIDNER",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-402-7496"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; 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.