Organization
DIVINE SAVIOR HEALTHCARE, INC.
Active
Parent organization
DIVINE SAVIOR HEALTHCARE, INC.
Other names
ASPIRUS PARDEEVILLE CLINIC
Organization subpart
Yes
Provider details
NPI number
Legal business name
DIVINE SAVIOR HEALTHCARE, INC.
Authorized official
MRS. LORI PECK (VP REVENUE CYCLE)
(715) 847-2988
Entity
Organization
Contact information
Practice address
102 GILLETTE STREET, PARDEEVILLE, WI 53954
(608) 429-2185
(608) 429-3966
Mailing address
2817 NEW PINERY ROAD, PORTAGE, WI 53901-0387
(608) 745-0560
(608) 742-6098
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32850500
—
WI
Enumeration date
10/25/2017
Last updated
08/26/2020
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