BETHANY HOME INC (NPI# 1215934963) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215934963 |
| Entity Type | Organization |
| Organization Name | BETHANY HOME INC |
| Practice Address |
1226 Berlin St Waupaca WI 54981-1991 |
| Practice Telephone | 7152585521 |
| Practice Fax Number | 7152587051 |
| Mailing Telephone | 7152585521 |
| Mailing Fax Number | 7152587051 |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. HANNAH GUTHO (ADMINISTRATOR) |
| Authorized Official Telephone | 7152585521 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 314000000X | Skilled Nursing Facility | 963 | WI | Nursing & Custodial Care Facilities |
| X | 310400000X | Assisted Living Facility | 1874 | WI | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 21054200 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841377389 | Bethany Home Inc | Assisted Living Facility | 515 W 1st Street, Minden, NE 68959-0150 | 2006-11-01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | BETHANY HOME INC | 1226 Berlin St, Waupaca, WI 54981-1991 |
| North Carolina Corporations | Bethany Home Inc. | 1716 Newton Street, Ocean Isle Beach, NC 28469 |
| Street Address |
1226 BERLIN ST |
| City | WAUPACA |
| State | WI |
| Zip Code | 54981-1991 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700431509 | Deborah Ann Wastart | Occupational Therapy Assistant | 1226 Berlin St, Waupaca, WI 54981-1991 | 2019-08-08 |
| 1396285102 | Meghan Renee Halambeck | Occupational Therapist | 1226 Berlin St, Waupaca, WI 54981-1991 | 2017-02-27 |
| 1356790117 | Sara Elizabeth Babbitts | Speech-Language Pathologist | 1226 Berlin St, Waupaca, WI 54981-1991 | 2016-06-11 |
| 1629418249 | Jessica Kossel | Speech-Language Pathologist | 1226 Berlin St, Waupaca, WI 54981-1991 | 2013-06-27 |
| 1750724704 | Dawn Lynne Johnson | Occupational Therapy Assistant | 1226 Berlin St, Waupaca, WI 54981-1991 | 2013-04-09 |
| 1275873846 | Laura Elizabeth Day | Occupational Therapy Assistant | 1226 Berlin St, Waupaca, WI 54981-1991 | 2013-02-19 |
| 1083982821 | Bonnie J Sperberg | Physical Therapist | 1226 Berlin St, Waupaca, WI 54981-1991 | 2011-12-07 |
| 1629345046 | Mary M Vodra | Speech-Language Pathologist | 1226 Berlin St, Waupaca, WI 54981-1991 | 2011-11-30 |
| 1407123771 | Kathryn Nancy Leeman | Physical Therapy Assistant | 1226 Berlin St, Waupaca, WI 54981-1991 | 2011-11-30 |
| 1730456286 | Susan Dorsett | Occupational Therapy Assistant | 1226 Berlin St, Waupaca, WI 54981-1991 | 2011-11-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366096141 | Renee Elizabeth Winn | Speech-Language Pathologist | 800 Riverside Drive Dr. 902 Building, Speech Therapy, Waupaca, WI 54981 | 2019-07-30 |
| 1891263216 | Stephanie Rice | Dental Hygienist | N4008 Morgan Dr, Waupaca, WI 54981 | 2018-11-03 |
| 1972092989 | Renew Physical Therapy and Wellness, LLC | Physical Therapist | N2919 County Road Qq, Waupaca, WI 54981 | 2018-05-04 |
| 1366942195 | Lanna Boyle | Physical Medicine & Rehabilitation | E1132 Hillcrest Dr, Waupaca, WI 54981 | 2018-02-19 |
| 1710333893 | Thedacare Medical Center - Waupaca, Inc. | General Acute Care Hospital | N2610 Wi 22, Waupaca, WI 54981 | 2016-05-09 |
| 1750743365 | Kimberly Marie Kraeger | Counselor | Waupaca County Dhhs, 811 Harding St, Waupaca, WI 54981 | 2016-03-23 |
| 1619211596 | Kari Anna Esbensen | Counselor | N2919 Cty Qq, Waupaca, WI 54981 | 2012-11-16 |
| 1396027629 | Roots Wholistic Health | Chiropractor | 717 Churchill St., Waupaca, WI 54981 | 2011-09-13 |
| 1629387006 | Barton Jerome Blum | General Practice | E1803 Melody Lane, Waupaca, WI 54981 | 2010-10-01 |
| 1710219357 | Anne Marie Collins-reed | Social Worker | 315 River Road, New London, WI 54981 | 2010-02-08 |
| Find all providers in zip 54981 | ||||
| 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 |
|---|---|---|---|---|
| 1780757872 | Extendicare Homes, Inc. | Skilled Nursing Facility | 1401 Churchill St, Waupaca, WI 54981-2027 | 2006-11-16 |
| 1093108565 | Crossroads Care Center of Crystal River LLC | Skilled Nursing Facility | 1401 Churchill St, Waupaca, WI 54981-2027 | 2015-03-09 |
| 1033511316 | Prostep Rehabilitation | Skilled Nursing Facility | 1401 Churchill St, Waupaca, WI 54981-2027 | 2014-09-18 |
| 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 | ||||
Please comment or provide details below to improve the information on BETHANY HOME INC.
| 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.