CLEARWATER CARE CENTER, LLC (NPI# 1003842873) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003842873 |
| Entity Type | Organization |
| Organization Name | CLEARWATER CARE CENTER, LLC |
| Other Organization Name | AMERICAN EAGLE NURSING HOME COMPANY OF EAU CLAIRE, LLC |
| Practice Address |
2120 Heights Drive Eau Claire WI 54701 |
| Mailing Address |
121 South Water Avenue Gallatin TN 37066-2902 |
| Practice Telephone | 7158321681 |
| Practice Fax Number | 7158317022 |
| Mailing Telephone | 6159897881 |
| Mailing Fax Number | 7158317022 |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2018-05-31 |
| Authorized Official Name | MR. DOUGLASS B. SMITH (PRESIDENT AND COO) |
| Authorized Official Telephone | 6156479004 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 3224 | WI | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 100007803 | 05 |
| Other Name | Type Code |
|---|---|
| American Eagle Nursing Home Company of Eau Claire, LLC | Former Legal Business Name - Organization |
| Street Address |
2120 HEIGHTS DRIVE |
| City | EAU CLAIRE |
| State | WI |
| Zip Code | 54701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649887563 | Molly Amanda Haferman | Pharmacist | 3184 London Road, Eau Claire, WI 54701 | 2020-09-24 |
| 1194375915 | Moments Hospice of Eau Claire LLC | Hospice Care, Community Based | 2263 East Ridge Center, Eau Claire, WI 54701 | 2019-09-13 |
| 1043778228 | Rita Marie Acosta | Emergency Medical Technician, Basic | 509 University Dr, Mcphee Atr, Eau Claire, WI 54701 | 2019-03-07 |
| 1619450954 | Michael Brown | Case Manager/Care Coordinator | 102 S Barstow St, Eau Claire, WI 54701 | 2018-09-12 |
| 1417436569 | Valerie Jayne Both | Social Worker | 1000 Starr Avenue, Eau Claire, WI 54701 | 2018-08-09 |
| 1023519055 | Rachel Delanois | Specialist/Technologist | Kinesiology --mcphee Physical Education Center 208, 509 University Drive, Eau Claire, WI 54701 | 2018-02-25 |
| 1427564863 | Matayla Springstroh | Specialist/Technologist | 509 University Drive, Eau Claire, WI 54701 | 2017-12-21 |
| 1265981062 | Molly Hart | Student in an Organized Health Care Education/Training Program | 509 University Dr., Eau Claire, WI 54701 | 2016-09-22 |
| 1982051918 | Renee Teigen-stary | Registered Nurse | 3440 Oakwood Hills Parkway, Eau Claire, WI 54701 | 2016-05-19 |
| 1699104059 | Susan Marie Keller | Speech-Language Pathologist | 3656 Mull Dr., Dove Healthcare - South, Eau Claire, WI 54701 | 2013-11-06 |
| Find all providers in zip 54701 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649447517 | Bonnie Jean Tibbitts | Skilled Nursing Facility | 4901 N Clairemont Ave, Eau Claire, WI 54703-3869 | 2008-05-10 |
| 1992745731 | Grace Lutheran Foundation, Inc. | Skilled Nursing Facility | 816 Porter Ave, Eau Claire, WI 54701-3813 | 2006-06-08 |
| 1215936430 | Covenant Healthcare, LLC | Skilled Nursing Facility | 1405 Truax Blvd, Eau Claire, WI 54703-1474 | 2005-07-19 |
| 1912901307 | Nasb Financial, Inc. | Skilled Nursing Facility | 2120 Heights Dr, Eau Claire, WI 54701-6142 | 2005-06-13 |
| 1417305640 | Dove Healthcare | Skilled Nursing Facility | 1405 Truax Blvd, Eau Claire, WI 54703-1474 | 2016-05-27 |
| 1255701165 | Grace Lutheran Foundation, Inc | Skilled Nursing Facility | 2116 Craig Road, Eau Claire, WI 54701 | 2015-10-05 |
| 1912304148 | Kyle Vande Hei | Skilled Nursing Facility | 1405 Truax Blvd, Eau Claire, WI 54703-1474 | 2014-12-03 |
| 1801293063 | Dove Healthcare | Skilled Nursing Facility | 1405 Truax Blvd, Eau Claire, WI 54703-1474 | 2014-12-03 |
| 1851728877 | Dove Healthcare | Skilled Nursing Facility | 1405 Truax Blvd, Eau Claire, WI 54703-1474 | 2013-10-04 |
| 1932470200 | Dove Healthcare | Skilled Nursing Facility | 1405 Truax Blvd, Eau Claire, WI 54703-1474 | 2012-01-19 |
| Find all providers in EAU CLAIRE | ||||
| City | EAU CLAIRE |
| Zip Code | 54701 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.