Provider Demographics
NPI:1043718497
Name:KISMET ADVOCACY LLC
Entity type:Organization
Organization Name:KISMET ADVOCACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER SERVICE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:JO
Authorized Official - Last Name:TIMM
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:920-309-2911
Mailing Address - Street 1:107 S OAKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54303-1628
Mailing Address - Country:US
Mailing Address - Phone:920-309-2911
Mailing Address - Fax:
Practice Address - Street 1:107 S OAKLAND AVE
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54303-1628
Practice Address - Country:US
Practice Address - Phone:920-309-2911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-30
Last Update Date:2018-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care