Healthcare Provider Details

I. General information

NPI: 1770675712
Provider Name (Legal Business Name): INNOVO HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 COMMERCE DR SUITE 200
HUDSON WI
54016-8278
US

IV. Provider business mailing address

625 COMMERCE DR STE 200
HUDSON WI
54016-8361
US

V. Phone/Fax

Practice location:
  • Phone: 715-377-9617
  • Fax: 715-377-9623
Mailing address:
  • Phone: 715-377-9617
  • Fax: 715-377-9623

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number1050
License Number StateWI

VIII. Authorized Official

Name: STEVEN JAMES ALESSANDRO
Title or Position: CEO
Credential:
Phone: 847-433-5650