Provider Demographics
NPI:1508218348
Name:HEALTH NETWORK OF WISCONSIN
Entity Type:Organization
Organization Name:HEALTH NETWORK OF WISCONSIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:NAVIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-763-5154
Mailing Address - Street 1:2457 N MAYFAIR RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-1405
Mailing Address - Country:US
Mailing Address - Phone:414-763-5154
Mailing Address - Fax:414-988-9308
Practice Address - Street 1:2457 N MAYFAIR RD
Practice Address - Street 2:SUITE 202
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226-1405
Practice Address - Country:US
Practice Address - Phone:414-763-5154
Practice Address - Fax:414-988-9308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-05
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care