# RELIV OF SOUTHERN WISCONSIN

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629217062
- **Authorized official:** MR. VITTORIO GIUSEPPE SPADARO SR. (CHAIRMAN VP NUTRITION)
- **Authorized official phone:** (920) 356-0681

## Contact information

- **Practice address:** 201 PRAIRIE VIEW DR, BEAVER DAM, WI 53916-3406
- **Practice address phone:** (920) 356-0681
- **Mailing address:** 305 S CLARK ST, MAYVILLE, WI 53050-1488
- **Mailing address phone:** (920) 356-0681

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 02/09/2009
- **Last updated:** 02/10/2009