Organization
DIVERGE HEALTH ACO OF SOUTHEAST MICHIGAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VINCENT PANTONE (CMO)
(941) 718-9000
Entity
Organization
Contact information
Practice address
500 ADAMS AVE, GLENCOE, IL 60022-1865
(941) 718-9000
Mailing address
500 ADAMS AVE, GLENCOE, IL 60022-1865
(941) 718-9000
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
03/15/2024
Last updated
05/17/2024
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