MEDICARE: DLHOMECARE 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
2	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1962221242
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DLHOMECARE LLC

Provider Business Mailing Address
First Line	:	N6160 KAPUR DR
Second Line	:
City	:	SHEBOYGAN FALLS
State	:	WI
Zip	:	53085-3399
Country	:	US
Telephone Number	:	608-630-1665
Fax Number	:

Provider Business Practice Location Address
First Line	:	N6160 KAPUR DR
Second Line	:
City	:	SHEBOYGAN FALLS
State	:	WI
Zip	:	53085-3399
Country	:	US
Telephone Number	:	608-630-1665
Fax Number	:

Authorized Official
Title or Position	:	OWNER/OPERATOR
Name	:	DAWN RIES
Credential	:
Telephone Number	:	608-630-1665

Provider Enumeration Date	:	10/04/2024
Last Update Date	:	10/04/2024

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