Life Enhancement Supportive Services

LBN: Life Enhancement Supportive Services
Life Enhancement Supportive Services is an health care organization with primary practice located at 6001 W Center St Ste 201 , Milwaukee WI 53210-2154. The organization recently has only one registered license in Agencies / Community/Behavioral Health, which is considered as the primary health care specialty. Life Enhancement Supportive Services can be contacted via phone (414) 444-2380, or through Ross, Tonyetta L via phone (414) 690-0672.

Contact Information

Primary practice address
6001 W Center St Ste 201 Milwaukee WI 53210-2154
Phone: (414) 444-2380
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Ross, Tonyetta L BS, SACIT
Phone: (414) 690-0672

Health care specialties

SpecialtyCodeLicense #State
Agencies / Community/Behavioral Health 251S00000X 15896-130 Wisconsin

Profile Details

NPI number 1790115954
LBN Legal business name Life Enhancement Supportive Services
DBA Doing business as
Authorized official Ross, Tonyetta L BS, SACIT
Entity Organization
Organization subpart 1 No
Enumeration date Nov 25th, 2013
Last updated Nov 25th, 2013 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790115954 NPPES
Wisconsin Other 12088599 CAQH
Wisconsin Other 1184060998 CAQH

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