EXTENDICARE HOMES, INC. (NPI# 1578635918) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578635918 |
| Entity Type | Organization |
| Organization Name | EXTENDICARE HOMES, INC. |
| Other Organization Name | WILLOWFIELD NURSING AND REHABILITATION CENTER |
| Practice Address |
905 E Geneva St Delavan WI 53115-1922 |
| Mailing Address |
111 W Michigan St Milwaukee WI 53203-2903 |
| Practice Telephone | 2627286319 |
| Practice Fax Number | 2627286693 |
| Mailing Telephone | 4149088119 |
| Mailing Fax Number | 4149087105 |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2020-08-22 |
| 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 |
|---|---|---|---|
| WI | 20175200 | 05 |
| Other Name | Type Code |
|---|---|
| Willowfield 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 |
905 E GENEVA ST |
| City | DELAVAN |
| State | WI |
| Zip Code | 53115-1922 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144835844 | Natalie Grace Trudell | Speech-Language Pathologist | 905 E Geneva St, Delavan, WI 53115-1922 | 2020-09-10 |
| 1700358132 | Ivy Lopez | Registered Nurse | 905 E Geneva St, Delavan, WI 53115-1922 | 2018-12-24 |
| 1679054639 | Shelby Marilyn Marie Kallio-crotteau | Physical Therapy Assistant | 905 E Geneva St, Delavan, WI 53115-1922 | 2018-08-27 |
| 1538687330 | Nsh Delavan LLC | Skilled Nursing Facility | 905 E Geneva St, Delavan, WI 53115-1922 | 2017-09-01 |
| 1962943696 | Melissa Hanna | Physical Therapy Assistant | 905 E Geneva St, Delavan, WI 53115-1922 | 2017-03-14 |
| 1659760452 | Fmg East Geneva Street Wisconsin LLC | Skilled Nursing Facility | 905 E Geneva St, Delavan, WI 53115-1922 | 2015-01-16 |
| 1649689738 | Ramon Alvarez IIi | Occupational Therapist | 905 E Geneva St, Delavan, WI 53115-1922 | 2014-08-04 |
| 1710317466 | Katherine Sween | Skilled Nursing Facility | 905 E Geneva St, Delavan, WI 53115-1922 | 2013-11-16 |
| 1639455835 | Rachel Marie Nordentoft | Occupational Therapy Assistant | 905 E Geneva St, Delavan, WI 53115-1922 | 2011-11-01 |
| 1952691446 | April Doebert-fischer | Occupational Therapist | 905 E Geneva St, Delavan, WI 53115-1922 | 2011-04-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871049486 | Careatc - Andes Candies | Clinic/Center | 1400 E. Eisconsin, Delavan, WI 53115 | 2016-09-01 |
| 1407255797 | Jill Catherine Adams | Contractor | N44556 Dam Rd, Delavan, WI 53115 | 2014-08-22 |
| 1487930350 | Sheryl Jacobson | Pharmacist | 445 S Wright Street, Delavan, WI 53115 | 2011-10-24 |
| 1407152556 | Cannula Ear Cozy LLC | Durable Medical Equipment & Medical Supplies | N2444 Doris St., Delavan, WI 53115 | 2011-02-08 |
| 1710172630 | Timothy J Rasmussen LLC | Chiropractor | 1407 Racine St, Suite D, Delavan, WI 53115 | 2007-09-13 |
| 1407065873 | Debora Lee Nevermann | Physical Therapist | 824 B East Geneva Street, Delavan, WI 53115 | 2007-05-22 |
| 1740493006 | Karen St John | Physical Therapy Assistant | 905 East Geneva Street, Delavan, WI 53115 | 2007-05-07 |
| 1043430390 | Kristin M Grenier | Physical Therapy Assistant | 824 B East Geneva St, Delavan, WI 53115 | 2007-04-27 |
| 1891852034 | Maria Teresa Galgano Chadha | Dentist | 608 E Walworth Ave, Delavan, WI 53115 | 2007-01-03 |
| 1942396718 | Clifford Robert Poplar | Internal Medicine | 915 Geneva Street, Delavan, WI 53115 | 2006-10-05 |
| Find all providers in zip 53115 | ||||
| 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 |
|---|---|---|---|---|
| 1538687330 | Nsh Delavan LLC | Skilled Nursing Facility | 905 E Geneva St, Delavan, WI 53115-1922 | 2017-09-01 |
| 1659760452 | Fmg East Geneva Street Wisconsin LLC | Skilled Nursing Facility | 905 E Geneva St, Delavan, WI 53115-1922 | 2015-01-16 |
| 1669877528 | Andrea Janaszek | Skilled Nursing Facility | 113 Elm St, Delavan, WI 53115-1618 | 2014-11-04 |
| 1710317466 | Katherine Sween | Skilled Nursing Facility | 905 E Geneva St, Delavan, WI 53115-1922 | 2013-11-16 |
| 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 |
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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.