MEDICARE: WITH LOVE HOME LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253J00000X	Foster Care Agency

General Provider Information

NPI Number	:	1104703099
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WITH LOVE HOME LLC

Provider Business Mailing Address
First Line	:	777 N VAN BUREN ST APT 1513
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53202-3861
Country	:	US
Telephone Number	:	414-530-7044
Fax Number	:

Provider Business Practice Location Address
First Line	:	2345 N 8TH ST # 1513
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53206-3106
Country	:	US
Telephone Number	:	414-530-7044
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LISA NETTERVILLE
Credential	:
Telephone Number	:	414-530-7044

Provider Enumeration Date	:	08/20/2025
Last Update Date	:	08/20/2025

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Directions to “WITH LOVE HOME LLC ” Practice Location

Language	Start Address	Practice Location

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