Active NPI
Elandis Supportive Living LLC
- Home Health Clinical Nurse Specialist
- Milwaukee, WI
National Provider Identifier
1962312165
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Clinical Nurse Specialist
- 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, 2026
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100394073 | Medicaid | WI |
National Provider Directory
National Provider DirectoryNPI 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.