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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