Provider Demographics
NPI:1699445791
Name:WOODS SUPPORTIVE SERVICES LLC
Entity type:Organization
Organization Name:WOODS SUPPORTIVE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:POINTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-499-9822
Mailing Address - Street 1:4451 N 36TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53209-5904
Mailing Address - Country:US
Mailing Address - Phone:414-499-9822
Mailing Address - Fax:414-662-5126
Practice Address - Street 1:4451 N 36TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53209-5904
Practice Address - Country:US
Practice Address - Phone:414-499-9822
Practice Address - Fax:414-662-5126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-20
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health