Healthcare Provider Details

I. General information

NPI: 1740342187
Provider Name (Legal Business Name): AURORA COMMUNITY HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 09/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

406 TECHNOLOGY DR E STE B
MENOMONIE WI
54751-2768
US

IV. Provider business mailing address

406 TECHNOLOGY DR E STE B
MENOMONIE WI
54751-2768
US

V. Phone/Fax

Practice location:
  • Phone: 715-235-4667
  • Fax:
Mailing address:
  • Phone: 715-235-4667
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number310
License Number StateWI

VIII. Authorized Official

Name: AVIS WOLSKE-BAKER
Title or Position: CAO
Credential:
Phone: 715-235-1839