BENEVOLENT CORPORATION CEDAR COMMUNITY (NPI# 1811997695) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811997695 |
| Entity Type | Organization |
| Organization Name | BENEVOLENT CORPORATION CEDAR COMMUNITY |
| Other Organization Name | CEDAR LAKE HEALTH AND REHABILITATION CENTER |
| Practice Address |
5595 County Road Z West Bend WI 53095-9224 |
| Practice Telephone | 2623062100 |
| Practice Fax Number | 2623062126 |
| Mailing Telephone | 2623062100 |
| Mailing Fax Number | 2623062126 |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2019-05-09 |
| Authorized Official Name | JOSEPH T PICHLER (VICE PRESIDENT OF FINANCE) |
| Authorized Official Telephone | 2623064212 |
| Is Organization Subpart | Y |
| Parent Organization Name | BENEVOLENT CORPORATION CEDAR COMMUNITY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 0705 | WI | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 20125800 | 05 |
| Other Name | Type Code |
|---|---|
| Cedar Lake Health and Rehabilitation Center | Doing Business As Name - Organization |
| Cedar Lake Health and Rehabilitation Center | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194909341 | Benevolent Corporation Cedar Community | Custodial Care Facility | 113 Cedar Ridge Dr, West Bend, WI 53095-3654 | 2007-12-24 |
| 1851391304 | Benevolent Corporation Cedar Community | Assisted Living Facility | 5577 Home Dr, West Bend, WI 53095-7616 | 2005-07-27 |
| 1487654935 | Benevolent Corporation Cedar Community | Assisted Living Facility | 5555 Cedar Bay, West Bend, WI 53095-7602 | 2005-07-27 |
| 1972054138 | Benevolent Corporation Cedar Community | Assisted Living Facility | 5595 County Road Z, West Bend, WI 53095-9224 | 2016-10-21 |
| 1639438716 | Benevolent Corporation Cedar Community | Assisted Living Facility | 101 Cedar Ln, Elkhart Lake, WI 53020-2142 | 2012-05-10 |
| 1669513560 | Benevolent Corporation Cedar Community | Skilled Nursing Facility | 5595 County Road Z, West Bend, WI 53095-9224 | 2007-02-12 |
| 1194877902 | Benevolent Corporation Cedar Community | Hospice Care, Community Based | 5595 County Road Z, West Bend, WI 53095-9224 | 2007-01-18 |
| 1740332907 | Benevolent Corporation Cedar Community | Home Health | 5595 County Road Z, West Bend, WI 53095-9224 | 2007-01-17 |
| 1154321602 | Benevolent Corporation Cedar Community | Pharmacy | 5595 County Road Z, West Bend, WI 53095-9224 | 2005-07-27 |
| Street Address |
5595 COUNTY ROAD Z |
| City | WEST BEND |
| State | WI |
| Zip Code | 53095-9224 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194720789 | Michael A Brodzeller | Physical Therapist | 5595 County Road Z, West Bend, WI 53095-9224 | 2005-06-20 |
| 1477161537 | Ashley Marie Groth | Physical Therapist | 5595 County Road Z, West Bend, WI 53095-9224 | 2020-07-15 |
| 1144867771 | Kelsey Kultgen | Occupational Therapy Assistant | 5595 County Road Z, West Bend, WI 53095-9224 | 2019-12-02 |
| 1033684402 | Daniel Steuer | Physical Therapy Assistant | 5595 County Road Z, West Bend, WI 53095-9224 | 2018-10-11 |
| 1548755416 | Brett Vollmer | Physical Therapist | 5595 County Road Z, West Bend, WI 53095-9224 | 2018-06-24 |
| 1871014316 | Lindsey Hamann | Speech-Language Pathologist | 5595 County Road Z, West Bend, WI 53095-9224 | 2017-07-06 |
| 1902347081 | Lee Anderson | Pharmacist | 5595 County Road Z, West Bend, WI 53095-9224 | 2017-03-09 |
| 1972054138 | Benevolent Corporation Cedar Community | Assisted Living Facility | 5595 County Road Z, West Bend, WI 53095-9224 | 2016-10-21 |
| 1871042929 | Susan Christensen | Physical Therapist | 5595 County Road Z, West Bend, WI 53095-9224 | 2016-09-30 |
| 1629440490 | Maricel Schulte | Speech-Language Pathologist | 5595 County Road Z, West Bend, WI 53095-9224 | 2015-10-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942820428 | David Fountain | Contractor | 726 Creedwood Lane, West Bend, WI 53095 | 2020-04-24 |
| 1922664358 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1745 South Main St, West Bend, WI 53095 | 2019-05-10 |
| 1912423773 | Michelle R Prentice | Family Medicine | West Bend Health Center, 1700 W. Paradise Drive, West Bend, WI 53095 | 2017-08-14 |
| 1386165918 | Quad/med, LLC | Clinic/Center | 432 E. Washington St. #1115, West Bend, WI 53095 | 2017-07-05 |
| 1508230632 | Jesen Daniel | Counselor | 111 East Washington St, Affiliated Clinical Services, West Bend, WI 53095 | 2015-12-01 |
| 1477965259 | Jenna Crofts | Specialist/Technologist | 1190 East Paradise Drive, West Bend, WI 53095 | 2014-05-28 |
| 1023436342 | Visionworks | Optometrist | 1437 S. Main St., West Bend, WI 53095 | 2014-04-03 |
| 1295157295 | Stephanie Rabe | Registered Nurse | 910 E. Paradise Drive, West Bend, WI 53095 | 2014-01-09 |
| 1477898815 | Ralph Norman Olsen | Pediatrics | 6267 Riesch Road, West Bend, WI 53095 | 2012-12-11 |
| 1932458536 | Joshua Aaron Barta | Dentist | 2090 Continental Drive, West Bend, WI 53095 | 2012-08-29 |
| Find all providers in zip 53095 | ||||
| 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 |
|---|---|---|---|---|
| 1346214087 | Careage Management LLC | Skilled Nursing Facility | 203 4th St, West Bend, IA 50597 | 2006-02-16 |
| 1376530626 | Samaritan Health Center Subacute Unit | Skilled Nursing Facility | 551 S Silverbrook Dr, West Bend, WI 53095-3868 | 2005-10-03 |
| 1457345795 | Washington County Wisconsin | Skilled Nursing Facility | 531 E Washington St, West Bend, WI 53095-2531 | 2005-09-01 |
| 1669513560 | Benevolent Corporation Cedar Community | Skilled Nursing Facility | 5595 County Road Z, West Bend, WI 53095-9224 | 2007-02-12 |
| 1750305520 | Washington County Wisconsin | Skilled Nursing Facility | 3200 Pleasant Valley Rd, West Bend, WI 53095-9274 | 2006-07-26 |
| 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.