Healthcare Provider Details

I. General information

NPI: 1124819081
Provider Name (Legal Business Name): HOME SWEET HOME ASSISTED LIVING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2025
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2333 W LANCASTER AVE
MILWAUKEE WI
53209-5649
US

IV. Provider business mailing address

2333 W LANCASTER AVE
MILWAUKEE WI
53209-5649
US

V. Phone/Fax

Practice location:
  • Phone: 414-539-6057
  • Fax: 414-539-6037
Mailing address:
  • Phone: 414-539-6057
  • Fax: 414-539-6037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MS. SAKOTA DAWN TRIPLETT
Title or Position: OWNER/OPERATOR
Credential: LICENSED PROVIDER
Phone: 414-469-7658