Provider Demographics
NPI:1124819081
Name:HOME SWEET HOME ASSISTED LIVING LLC
Entity type:Organization
Organization Name:HOME SWEET HOME ASSISTED LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SAKOTA
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:TRIPLETT
Authorized Official - Suffix:
Authorized Official - Credentials:LICENSED PROVIDER
Authorized Official - Phone:414-469-7658
Mailing Address - Street 1:2333 W LANCASTER AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53209-5649
Mailing Address - Country:US
Mailing Address - Phone:414-539-6057
Mailing Address - Fax:414-539-6037
Practice Address - Street 1:2333 W LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53209-5649
Practice Address - Country:US
Practice Address - Phone:414-539-6057
Practice Address - Fax:414-539-6037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-13
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No385H00000XRespite Care FacilityRespite Care