Healthcare Provider Details

I. General information

NPI: 1437949302
Provider Name (Legal Business Name): ALGOMA HEALTH OPCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2025
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 FREMONT ST
ALGOMA WI
54201-1948
US

IV. Provider business mailing address

7300 W DEAN RD APT 201W
MILWAUKEE WI
53223-2681
US

V. Phone/Fax

Practice location:
  • Phone: 920-487-5511
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: HERSHEY BERNATH
Title or Position: OPERATOR
Credential:
Phone: 646-483-3497