NPI 1225783913

Diversified Health and Supportive Services LLC

Organisation Home Health Agency Mequon, WI

Practice location

Address: 11520 N Port Washington Rd STE 208, Mequon, WI 53092-3432
Phone: (414) 651-5954
Mailing address: 2903 N 74th St APT 1, Milwaukee, WI 53210-1000

Authorised official

Name: Shauna Pettis
Title: Owner/Subadministrator
Phone: (414) 748-7776

Registered specialties

Home Health Agency Primary

Agencies Taxonomy 251E00000X

Other Home Health providers in Wisconsin →

Registry record

NPI: 1225783913
Entity type: Organization
NPI issued: 21 Feb 2022
Record last updated: 21 Feb 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.