Organization
BROTHERLY LOVE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA ELAINE SHAURETTE (OWNER/OPERATOR)
(920) 755-0011
Entity
Organization
Contact information
Practice address
1513 E FRANCES ST, APPLETON, WI 54911
(920) 755-0011
Mailing address
1513 E FRANCES ST, APPLETON, WI 54911
(920) 755-0011
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
12/12/2019
Last updated
12/12/2019
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