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Organization
THEDACARE ACO, LLC
Active
Organization
THEDACARE ACO, LLC
Active
Parent organization
THEDACARE, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
THEDACARE, INC.
Authorized official
MR. TIM OLSON CFO (CFO)
(920) 830-5950
Entity
Organization
Contact information
Practice address
122 E COLLEGE AVE, APPLETON, WI 54911-5794
(920) 830-5950
(920) 830-5910
Mailing address
122 E COLLEGE AVE, APPLETON, WI 54911-5794
(920) 830-5950
(920) 830-5910
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
NULL
Other
Enumeration date
08/27/2014
Last updated
08/27/2014
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