NPIMap

Organization Active NPI

Ethereal Muse Collective LLC

  • In Home Supportive Care Agency
  • Milwaukee, WI
National Provider Identifier
1962335059
Registry record updated Jun 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
ETHEREAL MUSE COLLECTIVE LLC
Practice address
4212 W Hawthorne Trace Rd Apt 206
Milwaukee, WI 53209-1023
Phone
(414) 236-2745
NPI assigned
Jun 8, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2026

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

Authorized official

Name
Lasheenia Evans, CNANPI 1144153362
Title
Owner
Phone
(414) 236-2745

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

4212 W Hawthorne Trace Rd Apt 206
Milwaukee, WI 53209-1023

Mailing address

4212 W Hawthorne Trace Rd Apt 206
Milwaukee, WI 53209-1023
Phone (414) 236-2745

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1780876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780876800000",
    "number": "1962335059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4212 W HAWTHORNE TRACE RD APT 206",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532091023",
            "telephone_number": "414-236-2745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4212 W HAWTHORNE TRACE RD APT 206",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532091023",
            "telephone_number": "414-236-2745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETHEREAL MUSE COLLECTIVE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-06-08",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-07",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "LASHEENIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "414-236-2745",
        "authorized_official_credential": "CNA"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jun 8, 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.