Healthcare Provider Details

I. General information

NPI: 1730004292
Provider Name (Legal Business Name): SELECT INTEGRITY FAMILY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

W6082 RIESS RD
JEFFERSON WI
53549-9401
US

IV. Provider business mailing address

W6082 RIESS RD
JEFFERSON WI
53549-9401
US

V. Phone/Fax

Practice location:
  • Phone: 920-650-7092
  • Fax:
Mailing address:
  • Phone: 920-650-7092
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MELISSA HUSSIN MELISSA HUSSIN
Title or Position: OWNER/OPERATOR
Credential: MELISSA HUSSIN
Phone: 920-650-7092