Provider Demographics
NPI:1598418493
Name:SUPPORTIVE LEARNING CARE 2
Entity Type:Organization
Organization Name:SUPPORTIVE LEARNING CARE 2
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:SLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-267-8200
Mailing Address - Street 1:1159 N OAKWOOD RD
Mailing Address - Street 2:
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54904-7736
Mailing Address - Country:US
Mailing Address - Phone:920-456-9963
Mailing Address - Fax:
Practice Address - Street 1:1159 N OAKWOOD RD
Practice Address - Street 2:
Practice Address - City:OSHKOSH
Practice Address - State:WI
Practice Address - Zip Code:54904-7736
Practice Address - Country:US
Practice Address - Phone:920-456-9963
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUPPORTIVE LEARNING CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-01-31
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care