Provider Demographics
NPI:1043869316
Name:S&S HOUSE OF HOPE, LLC
Entity Type:Organization
Organization Name:S&S HOUSE OF HOPE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHANIECE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-491-5891
Mailing Address - Street 1:5310 N 46TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53218-3423
Mailing Address - Country:US
Mailing Address - Phone:414-491-5891
Mailing Address - Fax:
Practice Address - Street 1:1664 TERRY DALE DR
Practice Address - Street 2:
Practice Address - City:WEST BEND
Practice Address - State:WI
Practice Address - Zip Code:53090-8934
Practice Address - Country:US
Practice Address - Phone:262-353-9256
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-09
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI00117629OtherWISCONSIN DEPARTMENT OF HEALTH SERVICES DQA