Organization Active NPI

Elandis Supportive Living LLC

  • Home Health Clinical Nurse Specialist
  • Milwaukee, WI
National Provider Identifier
1962312165
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Clinical Nurse SpecialistTaxonomy code 364SH0200X
Legal business name
ELANDIS SUPPORTIVE LIVING LLC
Practice address
8117 W Scranton PL
Milwaukee, WI 53218-3547
Phone
(414) 294-9123
NPI assigned
Sep 9, 2026
Last updated
Sep 9, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2026

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

Authorized official

Name
Olympia Johnson
Title
Owner
Phone
(414) 294-9123

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Clinical Nurse Specialist 364SH0200X NU Primary

Addresses

Primary practice location

8117 W Scranton PL
Milwaukee, WI 53218-3547

Mailing address

8117 W Scranton PL
Milwaukee, WI 53218-3547
Phone (414) 294-9123

Other identifiers 1

IdentifierTypeStateIssuer
100394073MedicaidWI

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1788912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788912000000",
    "number": "1962312165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8117 W SCRANTON PL",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532183547",
            "telephone_number": "414-294-9123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8117 W SCRANTON PL",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532183547",
            "telephone_number": "414-294-9123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELANDIS SUPPORTIVE LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-09",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "OLYMPIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "414-294-9123"
    },
    "taxonomies": [
        {
            "code": "364SH0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100394073",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; 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.