BEVERLY ENTERPRISES - WISCONSIN INC (NPI# 1083707517) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083707517 |
| Entity Type | Organization |
| Organization Name | BEVERLY ENTERPRISES - WISCONSIN INC |
| Other Organization Name | GOLDEN LIVINGCENTER - VALLEY OF HAYWARD |
| Practice Address |
10775 Nyman Ave Hayward WI 54843 |
| Practice Telephone | 7156342202 |
| Mailing Telephone | 7156342202 |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2014-07-17 |
| Authorized Official Name | HOLLY A RASMUSSEN-JONES (SECRETARY) |
| Authorized Official Telephone | 4792014835 |
| Is Organization Subpart | Y |
| Parent Organization Name | BEVERLY HEALTH AND REHABILITATION SERVICES INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | WI | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | SECURITY HP | 525434 | 01 |
| WI | MEDICA MEC | 71-00305 | 01 |
| WI | MEDICA CHOICE | 7122617 | 01 |
| WI | 20-1231-00 | 05 |
| Other Name | Type Code |
|---|---|
| Golden LivingCenter - Valley of Hayward | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972550176 | Beverly Enterprises - Wisconsin Inc | Skilled Nursing Facility | 300 Race St, Wisconsin Dells, WI 53965-1822 | 2006-05-31 |
| 1992752380 | Beverly Enterprises - Wisconsin Inc | Skilled Nursing Facility | 1703 60th St, Kenosha, WI 53140-3986 | 2006-05-30 |
| 1770530164 | Beverly Enterprises - Wisconsin Inc | Skilled Nursing Facility | 3129 Michigan Ave, Sheboygan, WI 53081-3062 | 2006-05-30 |
| Street Address |
10775 NYMAN AVE |
| City | HAYWARD |
| State | WI |
| Zip Code | 54843 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891394250 | Sarah Christine Sloan | Speech-Language Pathologist | 10775 Nyman Ave, Hayward, WI 54843-6484 | 2020-10-18 |
| 1134661853 | Nsh Valley of Hayward LLC | Skilled Nursing Facility | 10775 Nyman Ave, Hayward, WI 54843-6484 | 2016-11-11 |
| 1184005837 | Nancy Goethlich | Physical Therapy Assistant | 10775 Nyman Ave, Hayward, WI 54843-6484 | 2015-06-17 |
| 1598938623 | Sandra Elizabeth Mcgee | Occupational Therapist | 10775 Nyman Ave, Valley of Hayward, Hayward, WI 54843-6484 | 2008-04-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063011252 | Kelsey Eickstaedt | Pharmacist | 15594 State Hwy 77, Hayward, WI 54843 | 2020-10-20 |
| 1245687417 | Gary Girard | Counselor | 15655 W County Hwy B, Hayward, WI 54843 | 2016-05-18 |
| 1164844379 | Elizabeth Anne Johnson | Counselor | 10594 Main Street #1021, Hayward, WI 54843 | 2014-01-08 |
| 1376776922 | Amy Marilyn Billman | Massage Therapist | 11128n Highway 27/77, Hayward, WI 54843 | 2009-08-31 |
| 1700016516 | Kyra Rhodes Larson | Dentist | 15541w Hwy 77 East, Hayward, WI 54843 | 2009-07-15 |
| 1235383985 | Sara Jane Drost | Dental Hygienist | 15910 W Company Lake Road, Hayward, WI 54843 | 2008-11-07 |
| 1982856076 | Align Therapy,llc | In Home Supportive Care | 10767 Nyman Avenue, Hayward, WI 54843 | 2008-10-21 |
| 1316112477 | Michael John Larson | Hearing Instrument Specialist | 15612 Windrose Lane, #200, Hayward, WI 54843 | 2008-04-29 |
| 1679748966 | Gwendolyn Vinopal | Physical Therapist | 16014w Sleepy Hollow Drive, Hayward, WI 54843 | 2008-04-28 |
| 1558546523 | Ruth Anne Gillmor | Social Worker | 10610 Main, Hayward, WI 54843 | 2008-01-08 |
| Find all providers in zip 54843 | ||||
| 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 |
|---|---|---|---|---|
| 1811038425 | Hayward Convalescent LLC | Skilled Nursing Facility | 1832 B St, Hayward, CA 94541-3140 | 2007-02-08 |
| 1124104872 | Windsor Gardens Healthcare Ctr of Hayward, LLC | Skilled Nursing Facility | 1628 B St, Hayward, CA 94541-3020 | 2006-10-27 |
| 1841388451 | Garfield Nursing Home, Inc. | Skilled Nursing Facility | 494 Blossom Way, Hayward, CA 94541-1948 | 2006-10-10 |
| 1194835017 | Christian Retirement Center of Northern California | Skilled Nursing Facility | 22427 Montgomery St, Hayward, CA 94541-3945 | 2006-08-30 |
| 1730293820 | Ewch, Inc. | Skilled Nursing Facility | 1805 West St, Hayward, CA 94545-1932 | 2006-08-18 |
| 1699798033 | Nadhi Inc. | Skilled Nursing Facility | 26660 Patrick Ave, Hayward, CA 94544-3808 | 2006-07-26 |
| 1245287895 | D & R Rch Corporation | Skilled Nursing Facility | 21863 Vallejo St, Hayward, CA 94541-2523 | 2006-05-28 |
| 1609840115 | Grancare LLC | Skilled Nursing Facility | 27350 Tampa Ave, Hayward, CA 94544-4429 | 2006-02-14 |
| 1487627725 | Grancare LLC | Skilled Nursing Facility | 19700 Hesperian Blvd, Hayward, CA 94541-4704 | 2006-02-08 |
| 1801868302 | Hayward Hills Operating Company, Lp | Skilled Nursing Facility | 1768 B St, Hayward, CA 94541-3102 | 2006-02-07 |
| Find all providers in HAYWARD | ||||
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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.