Healthcare Provider Details

I. General information

NPI: 1841283934
Provider Name (Legal Business Name): ASPIRUS EXTENDED SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2005
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

585 PETERSON DR
PHILLIPS WI
54555-1418
US

IV. Provider business mailing address

29980 NETWORK PL
CHICAGO IL
60673-1299
US

V. Phone/Fax

Practice location:
  • Phone: 715-339-3113
  • Fax: 715-339-3117
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1131
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: JERRY YANG
Title or Position: SVP- CHIEF FINANCIAL OFFICER
Credential:
Phone: 715-847-2526