Petra's Living Assistance, LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

PETRA'S LIVING ASSISTANCE, LLC

Doing business as

Visiting Angels

Practice address

347 Park Ave
Pewaukee, WI 53072-3413

Phone

(262) 695-4418

Fax

(262) 695-7461

NPI assigned

Sep 26, 2016

Last updated

Sep 26, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Scott Stollenwerk

Title

Ceo

Phone

(262) 695-4418

Specialties & licenses 1

Addresses

Other names 1

• Visiting Angels Doing business as

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

{
    "created_epoch": "1474848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474848000000",
    "number": "1700335270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "347 PARK AVE",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530723413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "347 PARK AVE",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530723413",
            "telephone_number": "262-695-4418",
            "fax_number": "262-695-7461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETRA'S LIVING ASSISTANCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-26",
        "last_updated": "2016-09-26",
        "status": "A",
        "authorized_official_last_name": "STOLLENWERK",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "262-695-4418"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Visiting Angels",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• In Home Supportive Care Agency in Pewaukee, WI
• Providers in Pewaukee, WI by specialty
• In Home Supportive Care Agency in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2016; 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.