Healthcare Provider Details

I. General information

NPI: 1679706022
Provider Name (Legal Business Name): ASPIRUS STEVENS POINT HOSPITAL & CLINICS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2009
Last Update Date: 06/13/2024
Certification Date: 06/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 PRENTICE STREET NORTH
STEVENS POINT WI
54481
US

IV. Provider business mailing address

29980 NETWORK PL
CHICAGO IL
60673-1299
US

V. Phone/Fax

Practice location:
  • Phone: 715-345-5300
  • Fax:
Mailing address:
  • Phone: 715-847-2304
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number1217
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number1217 ST PT
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number1216 STPT
License Number StateWI

VIII. Authorized Official

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