BV/MSTAR CALEDONIA TENANT, LLC (NPI# 1851990436) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851990436 |
| Entity Type | Organization |
| Organization Name | BV/MSTAR CALEDONIA TENANT, LLC |
| Practice Address |
5737 Erie St Racine WI 53402-1970 |
| Practice Telephone | 2626396025 |
| Practice Fax Number | 2626395279 |
| Mailing Telephone | 2626396025 |
| Mailing Fax Number | 2626395279 |
| Enumeration Date | 2020-10-23 |
| Last Update Date | 2020-10-23 |
| Authorized Official Name | MR. HENRY JAMES VAUGHN (REIMBURSEMENT ANALYST) |
| Authorized Official Telephone | 2405956025 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311500000X | Alzheimer Center (Dementia Center) | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| The Woods of Caledonia | Doing Business As Name - Organization |
| Street Address |
5737 ERIE ST |
| City | RACINE |
| State | WI |
| Zip Code | 53402-1970 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932700994 | Woods of Caledonia Memory Care LLC | Assisted Living Facility | 5737 Erie St, Racine, WI 53402-1970 | 2020-11-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215586847 | Jennifer Ann Wagener | Technician | 1513 Melvin Ave, Racine, WI 53402 | 2019-09-06 |
| 1023530490 | Tahir Vora | Pharmacist | 6840 Middle Rd Apt 8, Racine, WI 53402 | 2017-07-07 |
| 1154852069 | Golden Path Services | Home Health | 1700 North Main Street, Upper, Racine, WI 53402 | 2017-03-22 |
| 1376842690 | Vashir Jim Xiong | Acupuncturist | 3726 Ruby Ave, Racine, WI 53402 | 2011-03-25 |
| 1215248927 | Andrew M Asbury | Family Medicine | 2408 Four Mile Rd, Racine, WI 53402 | 2010-06-28 |
| 1215058532 | Lakeshore Family Dental Care Sc | Dentist | 3903 Douglas Ave, Racine, WI 53402 | 2007-04-03 |
| 1679626915 | David Ramon Reesman | Dentist | 3900 North Bay Dr, Racine, WI 53402 | 2007-01-19 |
| 1639286958 | Mary E Pagano | Internal Medicine | 5333 Douglas Ave, Racine, WI 53402 | 2006-08-23 |
| 1881605111 | Caledonia Chiropractic Clinic, Sc | Chiropractor | 5401 Douglas Ave, Suite A, Racine, WI 53402 | 2006-08-11 |
| 1003923996 | David C Zablotney | Family Medicine | 5333 Douglas Ave, Racine, WI 53402 | 2006-08-24 |
| Find all providers in zip 53402 | ||||
| Taxonomy Code | 311500000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Alzheimer Center (Dementia Center) |
| A freestanding facility or special care unit of a long term care facility focusing on patient care of individuals diagnosed with dementia or Alzheimer’s Disease or their related diseases. Six elements of the facility/unit set it apart from other (the rest of the) facilities(y): Admission of residents with dementia (including those with Alzheimer's disease); Staff who are specially selected, trained, and supervised; Activities that are specifically designed for the cognitively impaired; A marketing of a special care unit in brochures; A high level of family involvement; and A physical environment designed to keep residents safe and segregated from other populations. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750996195 | Vesta Memory Care, LLC | Alzheimer Center (Dementia Center) | 3965 Bradee Rd, Brookfield, WI 53005-2166 | 2020-09-12 |
| 1225652225 | Forsetti-tennyson LLC | Alzheimer Center (Dementia Center) | 1936 Tennyson Ln, Madison, WI 53704-2391 | 2020-06-04 |
| 1336528629 | Sunstone Assisted Living LLC | Alzheimer Center (Dementia Center) | 7945 31st Ave, Kenosha, WI 53142-4617 | 2015-05-20 |
| 1871804492 | New Haven, Inc | Alzheimer Center (Dementia Center) | 1500 Arboretum Dr, Oshkosh, WI 54901-2790 | 2010-06-29 |
| 1346362639 | Burris Adult Family Home LLC | Alzheimer Center (Dementia Center) | 5249 N 37th Street, Milwaukee, WI 53209-4727 | 2007-04-06 |
| 1265090559 | Beaver Dam Assisted Living, LLC | Alzheimer Center (Dementia Center) | 104 Fakes Ct, Beaver Dam, WI 53916-2699 | 2019-05-31 |
| 1578990404 | Snh Se Tenant Trs, Inc | Alzheimer Center (Dementia Center) | 1125 N Edge Trl, Verona, WI 53593-2021 | 2013-10-10 |
| 1184973588 | Newcastle Senior Care, LLC | Alzheimer Center (Dementia Center) | 12600 N Port Washington Rd, Mequon, WI 53092-3469 | 2012-08-31 |
| 1639339518 | United Lutheran Program for The Aging, Inc. | Alzheimer Center (Dementia Center) | 4545 N 92nd St, Milwaukee, WI 53225 | 2008-06-13 |
| 1134196983 | Methodist Manor Health Center Inc | Alzheimer Center (Dementia Center) | 8615 W Beloit Rd, West Allis, WI 53227-3711 | 2006-03-01 |
| Find all providers with the same taxonomy | ||||
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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.