BENEVOLENT CORPORATION CEDAR COMMUNITY (NPI# 1194909341) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194909341 |
| Entity Type | Organization |
| Organization Name | BENEVOLENT CORPORATION CEDAR COMMUNITY |
| Practice Address |
113 Cedar Ridge Dr West Bend WI 53095-3654 |
| Mailing Address |
5595 County Road Z West Bend WI 53095-9224 |
| Practice Telephone | 2623388377 |
| Practice Fax Number | 2623389555 |
| Mailing Telephone | 2623062100 |
| Mailing Fax Number | 2623062126 |
| Enumeration Date | 2007-12-24 |
| Last Update Date | 2017-12-14 |
| Authorized Official Name | MR. CHRISTOPHER CHERNEY (CFO) |
| Authorized Official Telephone | 2623064212 |
| Is Organization Subpart | Y |
| Parent Organization Name | BENEVOLENT CORPORATION CEDAR COMMUNITY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311Z00000X | Custodial Care Facility | Nursing & Custodial Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851391304 | Benevolent Corporation Cedar Community | Assisted Living Facility | 5577 Home Dr, West Bend, WI 53095-7616 | 2005-07-27 |
| 1487654935 | Benevolent Corporation Cedar Community | Assisted Living Facility | 5555 Cedar Bay, West Bend, WI 53095-7602 | 2005-07-27 |
| 1972054138 | Benevolent Corporation Cedar Community | Assisted Living Facility | 5595 County Road Z, West Bend, WI 53095-9224 | 2016-10-21 |
| 1639438716 | Benevolent Corporation Cedar Community | Assisted Living Facility | 101 Cedar Ln, Elkhart Lake, WI 53020-2142 | 2012-05-10 |
| 1669513560 | Benevolent Corporation Cedar Community | Skilled Nursing Facility | 5595 County Road Z, West Bend, WI 53095-9224 | 2007-02-12 |
| 1194877902 | Benevolent Corporation Cedar Community | Hospice Care, Community Based | 5595 County Road Z, West Bend, WI 53095-9224 | 2007-01-18 |
| 1740332907 | Benevolent Corporation Cedar Community | Home Health | 5595 County Road Z, West Bend, WI 53095-9224 | 2007-01-17 |
| 1154321602 | Benevolent Corporation Cedar Community | Pharmacy | 5595 County Road Z, West Bend, WI 53095-9224 | 2005-07-27 |
| 1811997695 | Benevolent Corporation Cedar Community | Skilled Nursing Facility | 5595 County Road Z, West Bend, WI 53095-9224 | 2005-07-22 |
| Street Address |
113 CEDAR RIDGE DR |
| City | WEST BEND |
| State | WI |
| Zip Code | 53095-3654 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942820428 | David Fountain | Contractor | 726 Creedwood Lane, West Bend, WI 53095 | 2020-04-24 |
| 1922664358 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1745 South Main St, West Bend, WI 53095 | 2019-05-10 |
| 1912423773 | Michelle R Prentice | Family Medicine | West Bend Health Center, 1700 W. Paradise Drive, West Bend, WI 53095 | 2017-08-14 |
| 1386165918 | Quad/med, LLC | Clinic/Center | 432 E. Washington St. #1115, West Bend, WI 53095 | 2017-07-05 |
| 1508230632 | Jesen Daniel | Counselor | 111 East Washington St, Affiliated Clinical Services, West Bend, WI 53095 | 2015-12-01 |
| 1477965259 | Jenna Crofts | Specialist/Technologist | 1190 East Paradise Drive, West Bend, WI 53095 | 2014-05-28 |
| 1023436342 | Visionworks | Optometrist | 1437 S. Main St., West Bend, WI 53095 | 2014-04-03 |
| 1295157295 | Stephanie Rabe | Registered Nurse | 910 E. Paradise Drive, West Bend, WI 53095 | 2014-01-09 |
| 1477898815 | Ralph Norman Olsen | Pediatrics | 6267 Riesch Road, West Bend, WI 53095 | 2012-12-11 |
| 1932458536 | Joshua Aaron Barta | Dentist | 2090 Continental Drive, West Bend, WI 53095 | 2012-08-29 |
| Find all providers in zip 53095 | ||||
| Taxonomy Code | 311Z00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| A facility providing care that serves to assist an individual in the activities of daily living, such as assistance in walking, getting in and out of bed, bathing, dressing, feeding, and using the toilet, preparation of special diets, and supervision of medication that usually can be self-administered. Custodial care essentially is personal care that does not require the continuing attention of trained medical or paramedical personnel. |
| Notes: Source: Paraphrased from Section 3159 A3 of the Medicare Intermediary Manual. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023643699 | County of La Crosse | Custodial Care Facility | 994 Garland St E, West Salem, WI 54669 | 2020-03-04 |
| 1235763053 | County of La Crosse | Custodial Care Facility | 848 Garland St E, West Salem, WI 54669 | 2020-03-02 |
| 1265066096 | County of La Crosse | Custodial Care Facility | 998 Garland St E, West Salem, WI 54669 | 2020-03-02 |
| 1437409737 | Med Group Adult Day Care of Wi, LLC | Custodial Care Facility | 10549 W Forest Home Ave, Hales Corners, WI 53130-2057 | 2012-09-13 |
| 1164729877 | Licensed To Care | Custodial Care Facility | 5846 N 68th St, Milwaukee, WI 53218-1808 | 2011-02-15 |
| 1912156530 | Grace Adult Day Services - Altoona | Custodial Care Facility | 2441 New Pine Dr, Altoona, WI 54720-3300 | 2008-09-18 |
| 1396994992 | Grace Adult Day Services - Chippewa Falls | Custodial Care Facility | 2050 County Highway I, Chippewa Falls, WI 54729-4416 | 2008-09-18 |
| 1295803971 | Health Managment Consortium | Custodial Care Facility | 1133 4th Ave S, Park Falls, WI 54552-1922 | 2006-12-01 |
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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.