ST. MARY'S HOME FOR THE AGED, INC (NPI# 1609882448) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609882448 |
| Entity Type | Organization |
| Organization Name | ST. MARY'S HOME FOR THE AGED, INC |
| Practice Address |
1635 S 21st St Manitowoc WI 54220-6380 |
| Mailing Address |
1635 S 21st Street Manitowoc WI 54220-5652 |
| Practice Telephone | 9206847171 |
| Practice Fax Number | 9206840118 |
| Mailing Telephone | 9206847171 |
| Mailing Fax Number | 9206840118 |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2015-12-15 |
| Authorized Official Name | MR. FRANK SOLTYS (PRESIDNET/CEO/NHA/MSN) |
| Authorized Official Telephone | 9206847171 |
| Authorized Official Credential | NHA, MSN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 540 | WI | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 20136700 | 05 |
| Street Address |
1635 S 21ST ST |
| City | MANITOWOC |
| State | WI |
| Zip Code | 54220-6380 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447798228 | Casey William Lemay | Physical Therapy Assistant | 1635 S 21st St, Manitowoc, WI 54220-6380 | 2017-02-01 |
| 1528477023 | Naly Yang | Physician Assistant | 1635 S 21st St, Manitowoc, WI 54220-6380 | 2014-08-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235614843 | Katherine Borchardt | Registered Nurse | 3520 Foxfire Ct, Manitowoc, WI 54220 | 2018-09-28 |
| 1285128215 | Aurora Pharmacy Inc | Pharmacy | 3509 Dewey Street, Suite 100, Manitowoc, WI 54220 | 2018-06-22 |
| 1477937274 | Baycare Clinic LLP | Psychiatry & Neurology | 4801 Expo Drive, Manitowoc, WI 54220 | 2015-07-13 |
| 1831593821 | Brittany Camille Schultz | Acupuncturist | 2510 Washington Street, Manitowoc, WI 54220 | 2014-10-20 |
| 1710311261 | Brian E Weitz | Physical Therapy Assistant | 960 S. Rapids Rd., Manitowoc, WI 54220 | 2013-09-01 |
| 1134499080 | Total Renal Care Inc | Clinic/Center | 3303 Dewey St, Manitowoc, WI 54220 | 2012-01-10 |
| 1679858534 | Lisa M Noworatzky | Marriage & Family Therapist | 926 S. 8th St., Manitowoc, WI 54220 | 2011-10-11 |
| 1306177225 | Cynthia Fay Wenzel | Licensed Practical Nurse | 915 East Linden Avenue, Manitowoc, WI 54220 | 2010-01-15 |
| 1851550628 | Roundys Supermarkets Inc | Pharmacy | 3300 Calumet Ave, Manitowoc, WI 54220 | 2008-06-05 |
| 1851566079 | Jennifer C Mcwilliams | Registered Nurse | 1004 Nth 8th St., Manitowoc, WI 54220 | 2008-04-29 |
| Find all providers in zip 54220 | ||||
| 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 |
|---|---|---|---|---|
| 1265606206 | Kindred Inc. | Skilled Nursing Facility | 1445 N 7th St, Manitowoc, WI 54220-2011 | 2008-04-22 |
| 1801967443 | Arbors At Toledo, Inc. | Skilled Nursing Facility | 960 S Rapids Rd, Manitowoc, WI 54220-4146 | 2006-11-13 |
| 1518926211 | Shady Lane Home, Inc. | Skilled Nursing Facility | 1235 S 24th St, Manitowoc, WI 54220-5516 | 2006-03-21 |
| 1548264260 | Manitowoc Health Care Center LLC | Skilled Nursing Facility | 2021 S Alverno Rd, Manitowoc, WI 54220-9208 | 2005-06-10 |
| 1174011845 | Complete Care At Manitowoc LLC | Skilled Nursing Facility | 2021 S Alverno Rd, Manitowoc, WI 54220-9208 | 2018-04-27 |
| 1932627726 | Nsh Manitowoc LLC | Skilled Nursing Facility | 960 S Rapids Rd, Manitowoc, WI 54220-4146 | 2017-09-01 |
| 1992231625 | The Bay At North Ridge Health and Rehabilitation LLC | Skilled Nursing Facility | 1445 N 7th St, Manitowoc, WI 54220 | 2017-05-01 |
| 1962894295 | Fmg South Rapids Road Wisconsin LLC | Skilled Nursing Facility | 960 S Rapids Rd, Manitowoc, WI 54220-4146 | 2015-02-24 |
| 1285050765 | North Ridge Health Care LLC | Skilled Nursing Facility | 1445 N 7th St, Manitowoc, WI 54220-2011 | 2014-03-09 |
| 1437307923 | Christina Marie Skalecki | Skilled Nursing Facility | 960 S Rapids Rd, Manitowoc, WI 54220-4146 | 2008-09-09 |
| Find all providers in MANITOWOC | ||||
Please comment or provide details below to improve the information on ST. MARY'S HOME FOR THE AGED, 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.