FAIRHAVEN CORPORATION (NPI# 1083619761) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083619761 |
| Entity Type | Organization |
| Organization Name | FAIRHAVEN CORPORATION |
| Practice Address |
435 W Starin Rd Whitewater WI 53190-1133 |
| Practice Telephone | 2624733445 |
| Practice Fax Number | 2624735468 |
| Mailing Telephone | 2624733445 |
| Mailing Fax Number | 2624735468 |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2020-09-01 |
| Authorized Official Name | DAVID GACKSTATTER (DIRECTOR OF HR/BUSINESS SERVICES) |
| Authorized Official Telephone | 6083224331 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 1039 | WI | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 20130500 | 05 |
| Street Address |
435 W STARIN RD |
| City | WHITEWATER |
| State | WI |
| Zip Code | 53190-1133 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629563838 | Lynn A Treutel | Occupational Therapy Assistant | 435 W Starin Rd, Whitewater, WI 53190-1133 | 2018-06-29 |
| 1699272526 | Anna Marilyn Luterbach | Occupational Therapist | 435 W Starin Rd, Whitewater, WI 53190-1133 | 2018-04-08 |
| 1922463157 | Lauren Niemi | Physical Therapist | 435 W Starin Rd, Attn: Therapy, Whitewater, WI 53190-1133 | 2015-12-14 |
| 1275968026 | Ali Benson | Physical Therapist | 435 W Starin Rd, Whitewater, WI 53190-1133 | 2013-09-12 |
| 1568733046 | Sandra Jean Safer | Physical Therapy Assistant | 435 W Starin Rd, Whitewater, WI 53190-1133 | 2012-01-16 |
| 1215206594 | Laura Fritz | Physical Therapy Assistant | 435 W Starin Rd, Whitewater, WI 53190-1133 | 2011-12-15 |
| 1972788487 | Sharon Jo Martin | Massage Therapist | 435 W Starin Rd, 112 Aa, Whitewater, WI 53190-1133 | 2008-01-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962908608 | Shannon Bashor | Specialist/Technologist | 907 W Schwager Dr, Whitewater, WI 53190 | 2018-04-02 |
| 1922542695 | Terry Teipner | Counselor | 1173 W Main St Ste B, Whitewater, WI 53190 | 2016-12-14 |
| 1063800100 | Courtney Stefanski | Specialist/Technologist | 900 Schwager Drive, Whitewater, WI 53190 | 2014-12-23 |
| 1275942989 | Courtney Palubicki | Specialist/Technologist | 907 W. Schwager Drive, Whitewater, WI 53190 | 2014-08-06 |
| 1548491087 | Ann Marie Welch | Registered Nurse | 9640 N. County Line Rd, Whitewater, WI 53190 | 2009-07-31 |
| 1780801423 | Marsha Lee Mckinnon | Registered Nurse | 710 Starin Road, Whitewater, WI 53190 | 2007-04-20 |
| 1164599387 | Michael J Kellum | Emergency Medicine | W9575 Homburg Lane, Whitewater, WI 53190 | 2006-11-30 |
| 1861596371 | Brian William Veale | Chiropractor | 543 S Putnam St, Whitewater, WI 53190 | 2006-09-13 |
| 1629508908 | Erin Kae Clark | Specialist/Technologist | 800 W Main St, Williams Center 105g, Whitewater, WI 53190 | 2017-06-19 |
| 1952854150 | Rebecca K Hamman | Nurse Practitioner | 710 W Starin Rd, Whitewater, WI 53190 | 2016-07-25 |
| Find all providers in zip 53190 | ||||
| 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 |
|---|---|---|---|---|
| 1780679498 | Wheat State Manor, Inc | Skilled Nursing Facility | 601 S Main St, Whitewater, KS 67154-9700 | 2005-09-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356962369 | Heritage Assisted Living, LLC | Skilled Nursing Facility | 5020 S 107th St, Greenfield, WI 53228-3267 | 2020-04-30 |
| 1235762881 | Imr Oak Creek Opco, LLC | Skilled Nursing Facility | 2700 West Honadel Boulevard, Oak Creek, WI 53154 | 2020-02-21 |
| 1831693936 | Golden Years Nursing Home, Inc. | Skilled Nursing Facility | 611 Harmony Dr, Lake Geneva, WI 53147-8800 | 2018-03-22 |
| 1801302732 | Oak Park Place of Janesville, LLC | Skilled Nursing Facility | 700 Myrtle Way, Janesville, WI 53545-9101 | 2017-12-14 |
| 1235674839 | Zachary Rader | Skilled Nursing Facility | 645 N Church St, Elkhorn, WI 53121-2204 | 2017-01-05 |
| 1982155248 | The Bethany-st. Joseph Corporation D/b/a Prairie Pointe Rehab Suites | Skilled Nursing Facility | 286 N. Willson Dr, Altoona, WI 54720 | 2016-10-20 |
| 1316492317 | Darcy Christiansen | Skilled Nursing Facility | 4427 E Pic A Dilly Dr, Janesville, WI 53546-9606 | 2016-08-19 |
| 1366895583 | Jeffrey Alan Weinshrott | Skilled Nursing Facility | 336 Wisconsin Ave, Sheboygan, WI 53081-4183 | 2016-07-22 |
| 1720433378 | Kendra Meyers | Skilled Nursing Facility | 1806 N Hume Ave Apt 4, Marshfield, WI 54449-1677 | 2016-05-02 |
| 1952756991 | Grace Lutheran Foundation Inc | Skilled Nursing Facility | 206 North Willson Drive, Altoona, WI 54720 | 2016-04-27 |
| Find all providers with the same taxonomy | ||||
| City | WHITEWATER |
| Zip Code | 53190 |
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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.