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Organization
DIVINE REHABILITATION AND NURSING AT FENNIMORE LLC
Active
Organization
DIVINE REHABILITATION AND NURSING AT FENNIMORE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ISAAK MARKOVITS (MANAGING MEMBER)
(718) 753-0250
Entity
Organization
Contact information
Practice address
1850 11TH ST, FENNIMORE, WI 53809-1612
(608) 822-6100
Mailing address
1632 61ST ST, BROOKLYN, NY 11204-2109
(608) 448-6200
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20150500
—
WI
Enumeration date
01/30/2019
Last updated
01/14/2025
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