Supportive Home Living Services, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

SUPPORTIVE HOME LIVING SERVICES, INC.

Practice address

250 W Broadway Ste 2
Waukesha, WI 53186-4848

Phone

(262) 544-0687

Fax

(262) 544-0715

NPI assigned

Sep 23, 2008

Last updated

Sep 23, 2008By 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

Ms. Kelly Kingston

Title

Ceo

Phone

(262) 544-0687

Specialties & licenses 4

Addresses

Locations

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

{
    "created_epoch": "1222128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222128000000",
    "number": "1912157223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 W BROADWAY STE 2",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531864848",
            "telephone_number": "262-544-0687",
            "fax_number": "262-544-0715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 W BROADWAY STE 2",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531864848",
            "telephone_number": "262-544-0687",
            "fax_number": "262-544-0715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPPORTIVE HOME LIVING SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-23",
        "last_updated": "2008-09-23",
        "status": "A",
        "authorized_official_last_name": "KINGSTON",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "262-544-0687",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Sep 23, 2008; 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.