HEYDE HEALTH SYSTEM, INC (NPI# 1790771368) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790771368 |
| Entity Type | Organization |
| Organization Name | HEYDE HEALTH SYSTEM, INC |
| Other Organization Name | EAGLETON HOME FDD |
| Practice Address |
14135 150th Ave Bloomer WI 54724-4410 |
| Mailing Address |
345 Frenette Dr Chippewa Falls WI 54729-3372 |
| Practice Telephone | 7152886311 |
| Practice Fax Number | 7152886312 |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. DENNIS L HEYDE (PRESIDENT) |
| Authorized Official Telephone | 7157269094 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | 2970 | WI | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 20163600 | 05 |
| Other Name | Type Code |
|---|---|
| Eagleton Home FDD | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518953199 | Heyde Health System, Inc | Assisted Living Facility | 109 N 14th St, Black River Falls, WI 54615-1931 | 2005-09-20 |
| 1003802661 | Heyde Health System, Inc | Skilled Nursing Facility | 1311 Tyler St, Black River Falls, WI 54615-1564 | 2005-09-20 |
| Street Address |
14135 150TH AVE |
| City | BLOOMER |
| State | WI |
| Zip Code | 54724-4410 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134376577 | Heyde Health System Inc | Assisted Living Facility | 14135 150th Ave, Bloomer, WI 54724-4410 | 2008-08-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093064545 | Robin Lachance | Physical Therapy Assistant | 1731 17th Avenue, Bloomer, WI 54724 | 2012-08-30 |
| 1104051614 | Nancy L Stiehm | Home Health Aide | 721 Priddy St, Bloomer, WI 54724 | 2009-05-28 |
| 1508013566 | Dianne Marie Goettl | Reflexologist | 1610 Main Street, Bloomer, WI 54724 | 2008-08-21 |
| 1609956481 | Timothy John Peterson | Chiropractor | 10135 Hwy Ss, Bloomer, WI 54724 | 2006-10-16 |
| 1427058122 | Ronald J Reimer | Physician Assistant | 1501 Thompson St, Bloomer, WI 54724 | 2005-07-26 |
| 1851827752 | Kimberly Carol Nicolai | Physical Therapist | 1501 Thompson St, Bloomer, WI 54724 | 2017-05-11 |
| 1639430788 | Celestine Chukwunonso Odenigbo | Internal Medicine | 1501 Thompson St, Bloomer, WI 54724 | 2012-06-05 |
| 1124250436 | Tania Riske | Speech-Language Pathologist | 1501 Thompson St, Bloomer, WI 54724 | 2009-08-20 |
| 1922230259 | Amy Sue Hilbert | Speech-Language Pathologist | 1501 Thompson St, Bloomer, WI 54724 | 2009-08-20 |
| 1659527281 | Janki Natu Patel | Internal Medicine | 1501 Thompson St, Bloomer, WI 54724 | 2008-08-14 |
| Find all providers in zip 54724 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790036739 | United Care Homes of Wisconsin LLC | Intermediate Care Facility, Mentally Retarded | 338 Municipal Dr, West Bend, WI 53095-3510 | 2012-10-01 |
| 1114158029 | Mississippi Valley Health Services Commission | Intermediate Care Facility, Mentally Retarded | 902 Garland St E, West Salem, WI 54669-1308 | 2009-07-28 |
| 1891931085 | The Arc of Columbia County | Intermediate Care Facility, Mentally Retarded | 711 E Cook St, Portage, WI 53901-2300 | 2008-12-18 |
| 1871714543 | St. Coletta of Wisconsin | Intermediate Care Facility, Mentally Retarded | W4955 Us Highway 18, Jefferson, WI 53549-9702 | 2007-05-01 |
| 1841418415 | Mccarthy Nursing Home | Intermediate Care Facility, Mentally Retarded | 124 S Monroe St, Stoughton, WI 53589-2012 | 2007-04-20 |
| 1689890204 | Hoplite, Inc. | Intermediate Care Facility, Mentally Retarded | 1719 Washington Ave, Racine, WI 53403-2019 | 2007-04-18 |
| 1235225616 | State of Wisconsin | Intermediate Care Facility, Mentally Retarded | 2820 East Park Avenue, Chippewa Falls, WI 54729-0340 | 2006-10-05 |
| 1376531061 | Wi Il Senior Housing | Intermediate Care Facility, Mentally Retarded | 1002 Eueka Street, Ripon, WI 54971 | 2005-10-07 |
| 1265429278 | County of Grant - Orchard Manor Fdd | Intermediate Care Facility, Mentally Retarded | 8800 Hwy 61, Lancaster, WI 53813-9306 | 2005-10-04 |
| 1891781464 | Lakeview Health Center | Intermediate Care Facility, Mentally Retarded | 902 E Garland St, West Salem, WI 54669-1308 | 2005-09-20 |
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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.