Organization
DIVINE REHABILITATION AND NURSING AT ST CROIX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ISAAK MARKOVITS (MANAGING MEMBER)
(718) 753-0250
Entity
Organization
Contact information
Practice address
750 E LOUISIANA ST, SAINT CROIX FALLS, WI 54024-9501
(715) 483-9815
Mailing address
1632 61ST ST, BROOKLYN, NY 11204-2109
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20157500
—
WI
Enumeration date
01/30/2019
Last updated
08/28/2023
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