Healthcare Provider Details

I. General information

NPI: 1194098335
Provider Name (Legal Business Name): DLO PARTERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2012
Last Update Date: 04/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3073 S CHASE AVE STE 312
MILWAUKEE WI
53207-2638
US

IV. Provider business mailing address

3073 S CHASE AVE STE 312
MILWAUKEE WI
53207-2638
US

V. Phone/Fax

Practice location:
  • Phone: 414-239-2334
  • Fax: 414-755-4410
Mailing address:
  • Phone: 414-239-2334
  • Fax: 414-755-4410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number3016
License Number StateWI

VIII. Authorized Official

Name: MR. JEFF SCHULZ
Title or Position: OWNER
Credential:
Phone: 414-239-2334