Living Insight Supportive Services LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

105058-30 Issued in WI

Legal business name

LIVING INSIGHT SUPPORTIVE SERVICES LLC

Practice address

3065 N 124TH St Ste 203
Brookfield, WI 53005-3874

Phone

(262) 794-3374

Fax

(262) 794-3274

NPI assigned

Oct 9, 2017

Organization subpart

No

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

Authorized official

Name

Shelia Black

Title

Administrator

Phone

(262) 689-0028

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1507507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640131200000",
    "number": "1730699489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3065 N 124TH ST STE 203",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530053874",
            "telephone_number": "262-794-3374",
            "fax_number": "262-794-3274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3065 N 124TH ST STE 203",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530053874",
            "telephone_number": "262-794-3374",
            "fax_number": "262-794-3274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING INSIGHT SUPPORTIVE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-09",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "SHELIA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "262-689-0028"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "WI",
            "license": "105058-30",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100070961",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Brookfield, WI
• Providers in Brookfield, WI by specialty
• Home Health Agency in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2021; 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.