NPIMap

Organization Active NPI

Innovo Healthcare, LLC

Doing business as Interim HealthCare of Western Wisconsin

  • Home Health Agency
  • Hudson, WI
National Provider Identifier
1770675712
Registry record updated Sep 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
1050 Issued in WI
Legal business name
INNOVO HEALTHCARE, LLC
Doing business as
Interim HealthCare of Western Wisconsin
Practice address
625 Commerce Dr
Suite 200
Hudson, WI 54016-8278
Phone
(715) 377-9617
Fax
(715) 377-9623
NPI assigned
Sep 28, 2006
Last updated
Sep 30, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Steven James Alessandro
Title
Ceo
Phone
(847) 433-5650

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 1050 WI Primary

Addresses

Primary practice location

625 Commerce Dr
Suite 200
Hudson, WI 54016-8278

Mailing address

625 Commerce Dr Ste 200
Hudson, WI 54016-8361
Phone (715) 377-9617

Other identifiers 2

IdentifierTypeStateIssuer
43113900MedicaidWI
1050OtherWISTATE REGULAR HOME HEALTH

Other names 1

  • Interim HealthCare of Western Wisconsin Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120817000137 WI Part A Provider - Home Health Agency 0143476572 Practice locations: Eau Claire, WI; Hudson, WI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1770675712. Details of each certification follow.

Home health agency certification: CCN 527291

Legal name
INNOVO HEALTHCARE, LLC
Doing business as
INTERIM HEALTHCARE OF WESTERN WISCONSIN
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Sep 6, 2005
Last certification
Feb 11, 2020
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Apr 27, 2012 in MN
Enrollment address
625 Commerce Dr
Ste 200
Hudson, WI 54016-8361

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Home health agency

Medicare Care Compare
Listed as
Interim Healthcare of Western WisconsinCCN 527291 · All quality measures
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
Sep 6, 2005
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D1040308Interim Healthcare of Western Wisconsin625 Commerce Dr, Suite 200, Hudson, WI 54016Certificate of waiverJan 8, 2028

National Provider Directory

National Provider Directory
Tax ID family
Ability Network3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

4257 Southtowne Dr
Ste 3
Eau Claire, WI 54701
Phone (715) 834-1313

592 Outpost Cir
Ste H
Hudson, WI 54016
Phone (715) 377-9617

625 Commerce Dr
Ste 200
Hudson, WI 54016
Phone (715) 377-9617

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
James R Wesner Individual 5% Or Greater Indirect Ownership InterestChief Financial Officer Nov 30, 2020 45%
Operational/Managerial ControlCfo Nov 30, 2020
Laurie Mayfield Individual W-2 Managing EmployeeAd; Apr 18, 2024
Great Lakes Health Partners LLC Organization, Hudson, WI LLC 5% Or Greater Direct Ownership Interest Mar 16, 2020 100%
Preston Lucas Individual 5% Or Greater Indirect Ownership InterestCfo Jul 1, 2025 10%
Corporate OfficerCfo Jul 1, 2025 100%
Steven J Alessandro Individual 5% Or Greater Indirect Ownership InterestChief Executive Officer Nov 30, 2020 45%
Corporate OfficerChief Executive Officer Nov 30, 2020
Operational/Managerial ControlChief Executive Officer Nov 30, 2020

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 91

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 91

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759190400000",
    "number": "1770675712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 COMMERCE DR STE 200",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540168361",
            "telephone_number": "715-377-9617",
            "fax_number": "715-377-9623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 COMMERCE DR",
            "address_2": "SUITE 200",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540168278",
            "telephone_number": "715-377-9617",
            "fax_number": "715-377-9623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVO HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2025-09-30",
        "certification_date": "2025-09-30",
        "status": "A",
        "authorized_official_last_name": "ALESSANDRO",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "847-433-5650"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "WI",
            "license": "1050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43113900",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE REGULAR HOME HEALTH",
            "identifier": "1050",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd SteB",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Interim HealthCare of Western Wisconsin",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hudson, WI

Sources for this page

Verify at the official NPI Registry.