EXTENDICARE HEALTH FACILITIES, INC. (NPI# 1730251463) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730251463 |
| Entity Type | Organization |
| Organization Name | EXTENDICARE HEALTH FACILITIES, INC. |
| Other Organization Name | WILLOWBROOK NURSING & REHABILITATION CENTER |
| Practice Address |
901 Mulberry St Lake Mills WI 53551-1335 |
| Mailing Address |
111 W Michigan St Milwaukee WI 53203-2903 |
| Practice Telephone | 9206488344 |
| Practice Fax Number | 9206483441 |
| Mailing Telephone | 4149088119 |
| Mailing Fax Number | 4149087105 |
| Enumeration Date | 2006-11-15 |
| 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 | 20116200 | 05 |
| Other Name | Type Code |
|---|---|
| Willowbrook Nursing & Rehabilitation Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932427309 | Extendicare Health Facilities, Inc. | Skilled Nursing Facility | 1420 E Douglas Road, Mishawaka, IN 46545-1733 | 2010-05-11 |
| 1629141841 | Extendicare Health Facilities, Inc. | Skilled Nursing Facility | 1277 Country Club Rd, Monongahela, PA 15063-1057 | 2006-11-16 |
| 1992877633 | Extendicare Health Facilities, Inc. | Skilled Nursing Facility | 41 Rickel Rd, Sun Prairie, WI 53590-1840 | 2006-11-15 |
| 1023180734 | Extendicare Health Facilities, Inc. | Skilled Nursing Facility | 516 26th Ave, Monroe, WI 53566-1531 | 2006-11-15 |
| 1215009915 | Extendicare Health Facilities, Inc. | Skilled Nursing Facility | 1200 Braun Rd, Bethel Park, PA 15102-3106 | 2006-11-15 |
| 1144392879 | Extendicare Health Facilities, Inc. | Skilled Nursing Facility | 1610 Hoover St, New Holstein, WI 53061-1636 | 2006-11-15 |
| 1184796872 | Extendicare Health Facilities, Inc. | Skilled Nursing Facility | 305 S Clark St, Mayville, WI 53050-1488 | 2006-11-15 |
| 1174695886 | Extendicare Health Facilities, Inc. | Skilled Nursing Facility | 2727 W Mitchell St, Milwaukee, WI 53215-2259 | 2006-11-15 |
| 1073685756 | Extendicare Health Facilities, Inc. | Skilled Nursing Facility | 576 Fred Rogers Dr, Latrobe, PA 15650-3822 | 2006-11-15 |
| 1841362563 | Extendicare Health Facilities, Inc. | Skilled Nursing Facility | 827 Georges Station Rd, Greensburg, PA 15601-6457 | 2006-11-15 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | EXTENDICARE HEALTH FACILITIES, INC. | 3500 Lenox Road Ne, Suite 510, Atlanta, GA 30326 |
| Washington State Corporations | EXTENDICARE HEALTH FACILITIES, INC. | 3500 Lenox Rd Ne, Ste 510, Atlanta, GA 30326-4229 |
| Street Address |
901 MULBERRY ST |
| City | LAKE MILLS |
| State | WI |
| Zip Code | 53551-1335 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649798448 | Nsh Lake Mills LLC | Skilled Nursing Facility | 901 Mulberry St, Lake Mills, WI 53551-1335 | 2017-09-01 |
| 1750738381 | Alyssa Kelli Murfield | Physical Therapy Assistant | 901 Mulberry St, Lake Mills, WI 53551-1335 | 2016-05-24 |
| 1700278025 | Fmg Mulberry Street Wisconsin LLC | Skilled Nursing Facility | 901 Mulberry St, Lake Mills, WI 53551-1335 | 2015-02-24 |
| 1104215110 | Lindsey Maria Kastner | Physical Therapist | 901 Mulberry St, Lake Mills, WI 53551-1335 | 2015-01-14 |
| 1881096873 | Jason Hetelle | Speech-Language Pathologist | 901 Mulberry St, Lake Mills, WI 53551-1335 | 2014-09-22 |
| 1093130064 | Larissa Hampton | Occupational Therapist | 901 Mulberry St, Lake Mills, WI 53551-1335 | 2014-02-26 |
| 1346663200 | Kelly Foster | Speech-Language Pathologist | 901 Mulberry St, Lake Mills, WI 53551-1335 | 2014-01-29 |
| 1700226032 | Kelsey Lee Lack | Speech-Language Pathologist | 901 Mulberry St, Lake Mills, WI 53551-1335 | 2013-07-01 |
| 1457625923 | Debra Rose Fritz | Physical Therapy Assistant | 901 Mulberry St, Lake Mills, WI 53551-1335 | 2012-03-01 |
| 1376773499 | Willowbrook Nursing & Rehab Center | Skilled Nursing Facility | 901 Mulberry St, Lake Mills, WI 53551-1335 | 2009-07-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669793337 | Abigail Marie Mohoney | Speech-Language Pathologist | 901 Mulberry St., Lake Mills, WI 53551 | 2010-06-17 |
| 1467694828 | Penny Ann Mcknight | Registered Nurse | N7119 North Shore Rd, Lake Mills, WI 53551 | 2009-04-01 |
| 1982891289 | Assisted Living Concepts Inc | Assisted Living Facility | 300 Oneil Street, Lake Mills, WI 53551 | 2007-10-01 |
| 1184706160 | Steven John Fahsel | Dentist | 119 W Lake St, Lake Mills, WI 53551 | 2006-10-19 |
| 1245256015 | Jason Carl Gatlin | Physical Therapist | 200 East Tyrannena Road, Therapy and Sport Center, Lake Mills, WI 53551 | 2006-07-14 |
| 1558780221 | Whitney Marie Van Reesen | Family Medicine | 1025 Mulberry St, Lake Mills, WI 53551 | 2014-04-10 |
| 1265761969 | Leanne Anthon | Registered Nurse | 603 Fremont St, Lake Mills, WI 53551-1021 | 2009-12-09 |
| 1174806897 | Ear Clinic, LLC | Clinic/Center | 125b E Pine St, Lake Mills, WI 53551-1103 | 2011-09-20 |
| 1669602488 | Aadvantage Behavioral Healthcare, LLC | Clinic/Center | 125 E Pine St, Lake Mills, WI 53551-1103 | 2009-07-15 |
| 1710986096 | Christopher James Kroll | Chiropractor | 125a E Pine St, Lake Mills, WI 53551-1103 | 2005-07-19 |
| Find all providers in zip 53551 | ||||
| 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 |
|---|---|---|---|---|
| 1700888369 | Abcm Corporation | Skilled Nursing Facility | 406 S 10th Ave E, Lake Mills, IA 50450-1851 | 2005-08-12 |
| 1649798448 | Nsh Lake Mills LLC | Skilled Nursing Facility | 901 Mulberry St, Lake Mills, WI 53551-1335 | 2017-09-01 |
| 1700278025 | Fmg Mulberry Street Wisconsin LLC | Skilled Nursing Facility | 901 Mulberry St, Lake Mills, WI 53551-1335 | 2015-02-24 |
| 1376773499 | Willowbrook Nursing & Rehab Center | Skilled Nursing Facility | 901 Mulberry St, Lake Mills, WI 53551-1335 | 2009-07-23 |
| 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 | ||||
| City | LAKE MILLS |
| Zip Code | 53551 |
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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.