Organization
VIVENT HEALTH INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIM DYER (EXEC VP)
(866) 525-5484
Entity
Organization
Contact information
Practice address
1105 GRAND AVE, SUITE 1, SCHOFIELD, WI 54476-1168
(715) 355-6867
(715) 355-0640
Mailing address
820 N PLANKINTON AVE, MILWAUKEE, WI 53203-1802
(414) 225-1542
(414) 225-1575
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42228200
—
WI
Enumeration date
05/24/2011
Last updated
05/12/2022
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