MEDICARE: AMOROUSNESS PERSONAL CARE SERVICE 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1508674417
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMOROUSNESS PERSONAL CARE SERVICE LLC

Provider Business Mailing Address
First Line	:	5535 N 40TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53209-4619
Country	:	US
Telephone Number	:	414-837-1557
Fax Number	:

Provider Business Practice Location Address
First Line	:	5535 N 40TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53209-4619
Country	:	US
Telephone Number	:	414-837-1557
Fax Number	:

Authorized Official
Title or Position	:	OWNER/OPERATOR
Name	:	MS. DELNITA THOMAS
Credential	:
Telephone Number	:	414-837-1557

Provider Enumeration Date	:	12/23/2024
Last Update Date	:	12/23/2024

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