Diverge Health Aco of Ohio LLC

Organization Active NPI Case Management Agency · Glencoe, IL

NPI 1295513240 · NPPES record last updated Apr 9, 2024

Key facts

NPI
1295513240
Entity type
Organization (NPI type 2)
Primary specialty
Case Management Agency 251B00000X
Legal business name
DIVERGE HEALTH ACO OF OHIO LLC
Practice address
500 Adams Ave
Glencoe, IL 60022-1865
Phone
(941) 718-9000
NPI assigned
Sep 20, 2023
Organization subpart
No

Authorized official

Name
Vincent Pantone
Title
Cmo
Phone
(941) 718-9000

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Diverge Health Aco of Ohio LLC (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator
Group: 193400000X SINGLE SPECIALTY GROUP
171M00000X
Case Management Agency 251B00000X Yes

Addresses

Primary practice location

500 Adams Ave
Glencoe, IL 60022-1865

Mailing address

500 Adams Ave
Glencoe, IL 60022-1865
Phone (941) 718-9000

Other providers in Glencoe, IL

All providers in Glencoe, IL · Case Management Agency in Illinois

Sources for this page

Verify at the official NPI Registry.