LIFE ENHANCEMENT SUPPORTIVE SERVICES (NPI# 1790115954) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790115954 |
| Entity Type | Organization |
| Organization Name | LIFE ENHANCEMENT SUPPORTIVE SERVICES |
| Practice Address |
6001 W Center St Ste 201 Milwaukee WI 53210-2154 |
| Practice Telephone | 4144442380 |
| Mailing Telephone | 4144442380 |
| Enumeration Date | 2013-11-25 |
| Last Update Date | 2013-11-25 |
| Authorized Official Name | MS. TONYETTA L ROSS (DIRECTOR) |
| Authorized Official Telephone | 4146900672 |
| Authorized Official Credential | BS, SACIT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | 15896-130 | WI | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | CAQH | 12088599 | 01 |
| WI | NPI | 1184060998 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184060998 | Life Enhancement Supportive Services | Case Manager/Care Coordinator | 3537 N 57th St, Milwaukee, WI 53216-2819 | 2013-05-20 |
| Street Address |
6001 W CENTER ST STE 201 |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53210-2154 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215169362 | Kenneth Woodley | Counselor | 6001 W Center St Ste 201, Milwaukee, WI 53210-2154 | 2009-08-21 |
| 1205124823 | Marcus Thornton | Counselor | 6001 W Center St Ste 201, Milwaukee, WI 53210-2154 | 2011-07-17 |
| 1093042715 | Howard Kaufman | Social Worker | 6001 W Center St Ste 201, Milwaukee, WI 53210-2154 | 2009-11-17 |
| 1134455389 | Bernita Wright | Counselor | 6001 W Center St Ste 201, Milwaukee, WI 53210-2154 | 2009-10-22 |
| 1265768758 | Cheryl Walker-lloyd | Counselor | 6001 W Center St Ste 201, Milwaukee, WI 53210-2154 | 2009-10-19 |
| 1295060911 | Theresa Rollins | Counselor | 6001 W Center St Ste 201, Milwaukee, WI 53210-2154 | 2009-10-14 |
| 1003055047 | Affirmative Reaction | Community/Behavioral Health | 6001 W Center St Ste 201, Milwaukee, WI 53210-2154 | 2009-02-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700499514 | Mckenzie Lisa Lambeck | Non-emergency Medical Transport (VAN) | 3016a N 36th St, Milwaukee, WI 53210 | 2020-08-31 |
| 1922572312 | Walter's Second Chance of Milwaukee, LLC. | In Home Supportive Care | 3043 N. 29th Street, Milwaukee, WI 53210 | 2019-01-18 |
| 1407353469 | Angie F Caballero | Assisted Living Facility | 5918 N 62nd Street, Milwaukee, WI 53210 | 2018-04-06 |
| 1689182636 | Kimberly Casey | Counselor | 5325 W.burleigh, Milwaukee, WI 53210 | 2018-01-11 |
| 1336663640 | Daron Mosby | Counselor | 2643 N 55th St., 2643 N 55th St., Milwaukee, WI 53210 | 2017-07-28 |
| 1881117174 | Advance Home Care, LLC | In Home Supportive Care | 6001 W Center St Ste 98ll, Milwaukee, WI 53210 | 2017-07-19 |
| 1285181735 | Aurora Family Services | Clinic/Center | 3200 W. Highland Blvd, Aurora Family Services, Milwaukee, WI 53210 | 2016-09-01 |
| 1447625264 | Kimberly Beckham | Registered Nurse | 3040 N 40th Street, Milwaukee, WI 53210 | 2015-12-04 |
| 1033595319 | Wisconsin Lutheran Child & Family Service Inc. | Social Worker | 207 North Sherman Blvd, Milwaukee, WI 53210 | 2015-08-10 |
| 1346633112 | Quiana Davis | Licensed Practical Nurse | 2478 North 34th Street, Milwaukee, WI 53210 | 2015-03-18 |
| Find all providers in zip 53210 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558968990 | Zoran Jovicic | Community/Behavioral Health | 3239 S 58th St Unit 104, Milwaukee, WI 53219-4365 | 2020-10-08 |
| 1548816580 | Latara Williams | Community/Behavioral Health | 2447 N 50th St, Milwaukee, WI 53210-2815 | 2019-08-15 |
| 1942856091 | Kennedy's Circle of Wellness LLC | Community/Behavioral Health | 3614 W North Ave, Milwaukee, WI 53208-1416 | 2019-08-14 |
| 1205391828 | Jerome Pitchford | Community/Behavioral Health | 1220 W Atkinson Ave, Milwaukee, WI 53206-3024 | 2019-02-07 |
| 1194233718 | The Evolving Chair Counseling and Consulting Agency | Community/Behavioral Health | 3100 N 78th St, Milwaukee, WI 53222-3916 | 2018-01-17 |
| 1316453905 | D.a.a.n.i Professional Counseling Service LLC | Community/Behavioral Health | 2943 N 52nd St, Milwaukee, WI 53210-1610 | 2017-12-19 |
| 1932654845 | The Thresholds | Community/Behavioral Health | 6815 W Capitol Dr # 305, Milwaukee, WI 53216-2070 | 2016-08-20 |
| 1801341144 | Fly Philanthropy Inc | Community/Behavioral Health | 3352 N Palmer St, Milwaukee, WI 53212-1541 | 2016-08-16 |
| 1659726545 | Pathway Youth & Famiy Services | Community/Behavioral Health | 3879 N Port Washington Rd, Milwaukee, WI 53212-1180 | 2016-04-27 |
| 1528413671 | Adventures In Play, LLC | Community/Behavioral Health | 2118 E Kenilworth Pl, Lowr, Milwaukee, WI 53202-1327 | 2016-04-26 |
| Find all providers in MILWAUKEE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.