Provider Demographics
NPI:1275935645
Name:DLO PARTNERS LLC DBA BRIGHTSIDE HOME CARE
Entity Type:Organization
Organization Name:DLO PARTNERS LLC DBA BRIGHTSIDE HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:T
Authorized Official - Last Name:SCHULZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-239-2334
Mailing Address - Street 1:3073 S. CHASE AVE
Mailing Address - Street 2:STE. 312
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53207-2667
Mailing Address - Country:US
Mailing Address - Phone:414-239-2334
Mailing Address - Fax:414-755-3612
Practice Address - Street 1:3073 S CHASE AVE
Practice Address - Street 2:STE. 312
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53207-2638
Practice Address - Country:US
Practice Address - Phone:414-239-2334
Practice Address - Fax:414-755-3612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-17
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1180251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI3016Medicaid
WI100020113Medicaid