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General NPI Number Information
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NPI Number | 1275935645
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Entity Type | Organization
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Legal Business Name | DLO PARTNERS LLC DBA BRIGHTSIDE HOME CARE
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Dates
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Enumeration Date | 09/17/2014
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Last Update Date | 09/17/2014
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Provider Practice Location Address
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Address Line | 3073 S CHASE AVE STE. 312
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City | MILWAUKEE
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State | WI
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Zip | 53207-2638
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Country | US
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Telephone | 414-239-2334
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Fax | 414-755-3612
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Provider Business Mailing Address
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Address Line | 3073 S. CHASE AVE STE. 312
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City | MILWAUKEE
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State | WI
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Zip | 53207-2667
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Country | US
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Telephone | 414-239-2334
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Fax | 414-755-3612
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | JEFF T SCHULZ
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Credential |
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Telephone | 414-239-2334
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 1180
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License Number State | WI
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