EXTENDICARE HOMES, INC. (NPI# 1417021098) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417021098 |
| Entity Type | Organization |
| Organization Name | EXTENDICARE HOMES, INC. |
| Other Organization Name | PEMBROKE NURSING AND REHABILITATION CENTER |
| Practice Address |
124 W Nashville St Pembroke KY 42266-9763 |
| Mailing Address |
111 W Michigan St Milwaukee WI 53203-2903 |
| Practice Telephone | 2704754227 |
| Practice Fax Number | 2704754173 |
| Mailing Telephone | 4149088119 |
| Mailing Fax Number | 4149087105 |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2009-09-18 |
| Authorized Official Name | DONNA JO MAASSEN (DIRECTOR OF COMPLIANCE) |
| Authorized Official Telephone | 4149088119 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 12504809 | 05 | |
| KY | 12500880 | 05 |
| Other Name | Type Code |
|---|---|
| Pembroke Nursing and Rehabilitation Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740345800 | Extendicare Homes, Inc. | Assisted Living Facility | 100 E Dalke Ave, Spokane, WA 99208-1006 | 2006-12-27 |
| 1639245558 | Extendicare Homes, Inc. | Skilled Nursing Facility | 1902 Mead Ave, Sheboygan, WI 53081-6140 | 2006-11-24 |
| 1912070624 | Extendicare Homes, Inc. | Skilled Nursing Facility | 414 Robey St, Franklin, KY 42134-1034 | 2006-11-17 |
| 1043383771 | Extendicare Homes, Inc. | Skilled Nursing Facility | 2500 N Elm St, Henderson, KY 42420-2005 | 2006-11-17 |
| 1790859486 | Extendicare Homes, Inc. | Skilled Nursing Facility | 3431 N 13th St, Sheboygan, WI 53083-2938 | 2006-11-17 |
| 1871666560 | Extendicare Homes, Inc. | Skilled Nursing Facility | 1561 Newton Ave, Bowling Green, KY 42104-3238 | 2006-11-17 |
| 1215001862 | Extendicare Homes, Inc. | Skilled Nursing Facility | 619 W Walnut St, Milwaukee, WI 53212-3839 | 2006-11-17 |
| 1619041340 | Extendicare Homes, Inc. | Skilled Nursing Facility | 867 Mcguire Ave, Paducah, KY 42001-4036 | 2006-11-17 |
| 1255405700 | Extendicare Homes, Inc. | Skilled Nursing Facility | 2582 Cerulean Rd, Cadiz, KY 42211-9605 | 2006-11-17 |
| 1376617837 | Extendicare Homes, Inc. | Skilled Nursing Facility | 420 E Grundy Ave, Springfield, KY 40069-1173 | 2006-11-17 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | EXTENDICARE HOMES, INC. | 3500 Lenox Road Ne, Suite 510, Atlanta, GA 30326 |
| Washington State Corporations | EXTENDICARE HOMES, INC. | 3500 Lenox Rd Ne, Suite 510, Atlanta, GA 30326-4229 |
| Street Address |
124 W NASHVILLE ST |
| City | PEMBROKE |
| State | KY |
| Zip Code | 42266-9763 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760967079 | Pembroke Operating Company LLC | Skilled Nursing Facility | 124 W Nashville St, Pembroke, KY 42266-9763 | 2018-10-02 |
| 1376803551 | Pembroke Health Facilities Lp | Skilled Nursing Facility | 124 W Nashville St, Pembroke, KY 42266-9763 | 2012-05-22 |
| 1700101151 | Pro Step Rehab | Skilled Nursing Facility | 124 W Nashville St, Pembroke, KY 42266-9763 | 2010-03-29 |
| 1528265642 | Katherine Elizabeth Guy | Physical Therapy Assistant | 124 W Nashville St, Pembroke, KY 42266 | 2007-07-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881295392 | Chapelle Bell | In Home Supportive Care | 232 Dewey St, Pembroke, KY 42266 | 2020-11-03 |
| 1093912206 | Amy Regina Steele | Occupational Therapist | 124 West Nashville Street, Pembroke, KY 42266 | 2007-06-29 |
| 1578760575 | Reba Jo Boley | Speech-Language Pathologist | 124 West Nashville Street, Pembroke, KY 42266 | 2007-07-02 |
| 1417154469 | Janet L Moore | Occupational Therapy Assistant | 124 West Nashville Street, Pembroke, KY 42266 | 2007-07-02 |
| 1669679668 | Barbara Veronica Boren | Physical Therapy Assistant | 124 West Nashville Street, Pembroke, KY 42266-0249 | 2007-07-02 |
| 1811238629 | Playtime Pediatric Occupational Therapy | Early Intervention Provider Agency | 1155 Mason Ln, Pembroke, KY 42266-8620 | 2013-03-05 |
| 1275132433 | Jolene Carol Schmucker | Nurse Practitioner | 775 Pembroke Fairview Rd, Pembroke, KY 42266-9413 | 2020-10-20 |
| 1497985824 | Leslie Dawn Vass | Contractor | 1225 Pembroke Fairview Rd, Pembroke, KY 42266-9452 | 2009-07-20 |
| 1932213550 | Mary Anne Jorgensen | Occupational Therapist | 1477 Pruitt Ln, Pembroke, KY 42266-9742 | 2006-08-19 |
| 1447424171 | Shelley Hill Payne | Speech-Language Pathologist | 1600 Pembroke Oak Grove Rd, Pembroke, KY 42266-9760 | 2008-04-14 |
| Find all providers in zip 42266 | ||||
| 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 |
|---|---|---|---|---|
| 1194779504 | Sunbridge Retirement Care Associates LLC | Skilled Nursing Facility | 310 E Wardell Rd, Pembroke, NC 28372-7997 | 2006-05-20 |
| 1760967079 | Pembroke Operating Company LLC | Skilled Nursing Facility | 124 W Nashville St, Pembroke, KY 42266-9763 | 2018-10-02 |
| 1376803551 | Pembroke Health Facilities Lp | Skilled Nursing Facility | 124 W Nashville St, Pembroke, KY 42266-9763 | 2012-05-22 |
| 1700101151 | Pro Step Rehab | Skilled Nursing Facility | 124 W Nashville St, Pembroke, KY 42266-9763 | 2010-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578163697 | Providence Point Healthcare, Inc. | Skilled Nursing Facility | 100 Marshall Ct, Paducah, KY 42001-9639 | 2020-10-28 |
| 1366062432 | Exceptional Senior Living-prospect, LLC | Skilled Nursing Facility | 6901 Carslaw Ct, Prospect, KY 40059-8358 | 2020-04-20 |
| 1811527617 | Trilogy Healthcare of Bullitt, LLC | Skilled Nursing Facility | 119 East Sanders Lane, Mt. Washington, KY 40047 | 2020-01-21 |
| 1659856961 | Salyersville Health Operating Company LLC | Skilled Nursing Facility | 662 Parkway Dr, Salyersville, KY 41465-9249 | 2018-10-02 |
| 1104307271 | Boonespring Transitional Care Center, LLC | Skilled Nursing Facility | 10250 Us 42, Union, KY 41091 | 2018-08-27 |
| 1740710623 | Landmark of Louisville Rehabilitation and Nursing Center | Skilled Nursing Facility | 1155 Eastern Parkway, Louisville, KY 40217 | 2017-06-14 |
| 1437682309 | Landmark of Lancaster Rehabilitation and Nursing Center | Skilled Nursing Facility | 308 W Maple Ave, Lancaster, KY 40444-1005 | 2017-04-07 |
| 1962954529 | Martin Manor Operations, LLC | Skilled Nursing Facility | 62 Maude Rd., Inez, KY 41224 | 2016-10-31 |
| 1023560661 | Robertson Operations, LLC | Skilled Nursing Facility | Route 2 Hwy 62, Mt. Olivet, KY 41064 | 2016-10-31 |
| 1205386208 | Vanceburg Leasing, LLC | Skilled Nursing Facility | 58 Eastham St, Vanceburg, KY 41179-5462 | 2016-10-13 |
| Find all providers with the same taxonomy | ||||
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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.