JACKSON INDEPENDENT LIVING, LLC. (NPI# 1013422567) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013422567 |
| Entity Type | Organization |
| Organization Name | JACKSON INDEPENDENT LIVING, LLC. |
| Practice Address |
2200 N Commerce St Milwaukee WI 53212-3497 |
| Mailing Address |
N67w13215 Daylily Dr Menomonee Falls WI 53051-0504 |
| Practice Telephone | 2626132960 |
| Enumeration Date | 2017-12-06 |
| Last Update Date | 2018-06-16 |
| Authorized Official Name | JIHAD JACKSON (CEO) |
| Authorized Official Telephone | 2626132960 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 253Z00000X | In Home Supportive Care | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 823587205 | 05 |
| Street Address |
2200 N COMMERCE ST |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53212-3497 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609481001 | Beth Leanna | Counselor | Benedict Center 1849 N Dr. Marin Luther King Dr., Suite 101, Milwaukee, WI 53212 | 2020-09-11 |
| 1326683749 | A.b.d.h. Counseling Services LLC | Clinic/Center | 518 E Concordia Avenue, Milwaukee, WI 53212 | 2019-11-08 |
| 1467095703 | Ifrah Hameed | Psychologist | 1849 N Doctor M.l.k. Jr Dr# 101, Milwaukee, WI 53212 | 2019-10-18 |
| 1386293330 | Rachel Mae Nelson Bagha | Student in an Organized Health Care Education/Training Program | 1849 N Doctor M.l.k. Jr Dr #101, Milwaukee, WI 53212 | 2019-09-11 |
| 1164085205 | Mary Sue Daase Bowen | Counselor | 2821 N 4th Street, Milwaukee, WI 53212 | 2019-04-15 |
| 1649733189 | Stacey King | Counselor | Rivershore Comprehensive Treatment Facility, 3703 N Richards St, Milwaukee Wi, Milwaukee, WI 53212 | 2019-04-11 |
| 1710447701 | Scott William Stauder | Student in an Organized Health Care Education/Training Program | 1121 E. North Ave., Milwaukee, WI 53212 | 2019-03-25 |
| 1821561168 | Lydia Ann Mendez | Counselor | 3703 N Richards St, Milwaukee, WI 53212 | 2019-01-09 |
| 1851863302 | Glen Victor Fleming | Counselor | 2821 North 4th Street Suite 210, Milwaukee, WI 53212 | 2018-12-21 |
| 1093285140 | Megan Marie Volp | Advanced Practice Midwife | 2555 N Doctor M.l.k. Jr Dr, Milwaukee, WI 53212 | 2018-12-03 |
| Find all providers in zip 53212 | ||||
| Taxonomy Code | 253Z00000X |
| Grouping | Agencies |
| Classification | In Home Supportive Care |
| An In Home Supportive Care Agency provides services in the patient’s home with the goal of enabling the patient to remain at home. The services provided may include personal care services such as hands-on assistance with activities of daily living (ADLs), e.g., eating, bathing, dressing, and bladder and bowel requirements; homemaker services and instrumental activities of daily living (IADLs), e.g., taking medications, shopping for groceries, laundry, housekeeping, and companionship; and/or supervision or cuing so that a person can perform tasks themselves. |
| Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871191346 | Beyond Care Services | In Home Supportive Care | 728 W Historic Mitchell St, Milwaukee, WI 53204-3528 | 2020-10-15 |
| 1013524966 | Esperanza Home Care, LLC | In Home Supportive Care | 4369 S Howell Ave Ste 304, Milwaukee, WI 53207-5055 | 2020-09-24 |
| 1265040711 | Diversity Home Health Services | In Home Supportive Care | 5757 W Oklahoma Ave Ste 200, Milwaukee, WI 53219-4303 | 2020-07-21 |
| 1487262457 | Sister & Sister Home Healthcare LLC | In Home Supportive Care | 2672 N 67th St Apt 2, Milwaukee, WI 53213-1461 | 2020-07-16 |
| 1134740368 | Right At Home LLC | In Home Supportive Care | 313 N Plankinton Ave Ste 205, Milwaukee, WI 53203-3104 | 2020-04-28 |
| 1760010243 | Prairieland Health Service, LLC | In Home Supportive Care | 814 N 26th St, Milwaukee, WI 53233-1508 | 2020-03-30 |
| 1750914669 | Inner City Compassionate Care LLC | In Home Supportive Care | 6830 W Villard Ave Ste 307, Milwaukee, WI 53218-3968 | 2020-02-19 |
| 1699312124 | Urban Leaders-mke | In Home Supportive Care | 5514 W Lisbon Ave, Milwaukee, WI 53210-2755 | 2019-12-03 |
| 1649812199 | Community Connections Family Resource Center,llc | In Home Supportive Care | 9330 W Lincoln Ave Ste A22, Milwaukee, WI 53227-2300 | 2019-10-16 |
| 1194372243 | Joshua Rashad Jackson Sr. | In Home Supportive Care | 6340 N 84th St Apt 5, Milwaukee, WI 53225-1972 | 2019-08-22 |
| 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.