EXTENDICARE HOMES, INC. (NPI# 1922179597) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922179597 |
| Entity Type | Organization |
| Organization Name | EXTENDICARE HOMES, INC. |
| Other Organization Name | HOSPITALITY NURSING & REHABILITATION CENTER |
| Practice Address |
8633 32nd Ave Kenosha WI 53142-5187 |
| Mailing Address |
111 W Michigan St Milwaukee WI 53203-2903 |
| Practice Telephone | 2626948300 |
| Practice Fax Number | 2626943622 |
| Mailing Telephone | 4149088119 |
| Mailing Fax Number | 4149087105 |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2008-04-11 |
| 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 | 20116100 | 05 |
| Other Name | Type Code |
|---|---|
| Hospitality Nursing & Rehabilitation Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740345800 | Extendicare Homes, Inc. | Assisted Living Facility | 100 E Dalke Ave, Spokane, WA 99208-1006 | 2006-12-27 |
| 1639245558 | Extendicare Homes, Inc. | Skilled Nursing Facility | 1902 Mead Ave, Sheboygan, WI 53081-6140 | 2006-11-24 |
| 1912070624 | Extendicare Homes, Inc. | Skilled Nursing Facility | 414 Robey St, Franklin, KY 42134-1034 | 2006-11-17 |
| 1043383771 | Extendicare Homes, Inc. | Skilled Nursing Facility | 2500 N Elm St, Henderson, KY 42420-2005 | 2006-11-17 |
| 1790859486 | Extendicare Homes, Inc. | Skilled Nursing Facility | 3431 N 13th St, Sheboygan, WI 53083-2938 | 2006-11-17 |
| 1871666560 | Extendicare Homes, Inc. | Skilled Nursing Facility | 1561 Newton Ave, Bowling Green, KY 42104-3238 | 2006-11-17 |
| 1215001862 | Extendicare Homes, Inc. | Skilled Nursing Facility | 619 W Walnut St, Milwaukee, WI 53212-3839 | 2006-11-17 |
| 1619041340 | Extendicare Homes, Inc. | Skilled Nursing Facility | 867 Mcguire Ave, Paducah, KY 42001-4036 | 2006-11-17 |
| 1255405700 | Extendicare Homes, Inc. | Skilled Nursing Facility | 2582 Cerulean Rd, Cadiz, KY 42211-9605 | 2006-11-17 |
| 1376617837 | Extendicare Homes, Inc. | Skilled Nursing Facility | 420 E Grundy Ave, Springfield, KY 40069-1173 | 2006-11-17 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | EXTENDICARE HOMES, INC. | 3500 Lenox Road Ne, Suite 510, Atlanta, GA 30326 |
| Street Address |
8633 32ND AVE |
| City | KENOSHA |
| State | WI |
| Zip Code | 53142-5187 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356942593 | Enhance Rehabilitation | Clinic/Center | 8633 32nd Ave, Kenosha, WI 53142-5187 | 2020-11-04 |
| 1396236808 | Rayme White | Occupational Therapist | 8633 32nd Ave, Kenosha, WI 53142-5187 | 2018-05-21 |
| 1083127641 | Crossroads Care Center of Kenosha | Skilled Nursing Facility | 8633 32nd Ave, Kenosha, WI 53142-5187 | 2017-11-06 |
| 1295253045 | Nsh Kenosha LLC | Skilled Nursing Facility | 8633 32nd Ave, Kenosha, WI 53142-5187 | 2017-08-31 |
| 1457874802 | Sarah Kramer | Occupational Therapy Assistant | 8633 32nd Ave, Kenosha, WI 53142-5187 | 2017-07-18 |
| 1598214363 | Ihc-snf LLC | Internal Medicine | 8633 32nd Ave, Kenosha, WI 53142-5187 | 2016-09-22 |
| 1912399239 | Fmg 32nd Avenue Wisconsin LLC | Skilled Nursing Facility | 8633 32nd Ave, Kenosha, WI 53142-5187 | 2015-02-24 |
| 1275870784 | Theresa Anderson | Occupational Therapist | 8633 32nd Ave, Kenosha, WI 53142-5187 | 2013-01-04 |
| 1760743629 | Jessica Turkowski | Physical Therapist | 8633 32nd Ave, Kenosha, WI 53142-5187 | 2012-06-06 |
| 1548546005 | Laura Bailey | Physical Therapy Assistant | 8633 32nd Ave, Kenosha, WI 53142-5187 | 2011-10-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588297816 | Caring Hearts Home Health Care | In Home Supportive Care | 6021-57th Ave, Suite C103, Kenosha, WI 53142 | 2020-02-14 |
| 1144785395 | Michael L Wrzesinski | Counselor | 4109 67th Street, Kenosha, WI 53142 | 2019-02-01 |
| 1720538499 | David Smith | Counselor | 10900 67th Street, Kenosha, WI 53142 | 2016-10-06 |
| 1326404641 | Smile Doctors Ltd | Dentist | 7003 39th Ave, Kenosha, WI 53142 | 2016-01-04 |
| 1225409485 | Antonia Marie Decker | Physician Assistant | 10400 75th St. Ste 204, Kenosha, WI 53142 | 2015-10-14 |
| 1780060582 | Joshua Haas | Pharmacist | 7701 Green Bay Road, Kenosha, IL 53142 | 2015-08-04 |
| 1811379225 | Dana Mary Stout | Registered Nurse | 7401 104th Avenue, Suite 110, Comprehensive Orthopaedics, S.c., Kenosha, WI 53142 | 2015-06-22 |
| 1669815569 | Joshua Knute Elson | Radiology | 6811 118th Ave, Kenosha, WI 53142 | 2013-04-10 |
| 1356610166 | Michael J Gallo | Pharmacist | 7535 North Greenbay Rd, Kenosha, WI 53142 | 2011-12-22 |
| 1720357999 | Orest Carnevale | Registered Nurse | 7316 155th Ct, Kenosha, WI 53142 | 2011-12-18 |
| Find all providers in zip 53142 | ||||
| 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 |
|---|---|---|---|---|
| 1801006978 | Midway Manor Corp. | Skilled Nursing Facility | 1519 60th St, Kenosha, WI 53140-3954 | 2007-05-23 |
| 1992752380 | Beverly Enterprises - Wisconsin Inc | Skilled Nursing Facility | 1703 60th St, Kenosha, WI 53140-3986 | 2006-05-30 |
| 1609823723 | Heartland-washington Manor of Kenosha Wi LLC | Skilled Nursing Facility | 3100 Washington Rd, Kenosha, WI 53144-1604 | 2006-05-27 |
| 1558329185 | Brookside Care Center | Skilled Nursing Facility | 3506 Washington Rd, Kenosha, WI 53144 | 2006-05-03 |
| 1740270735 | St. Joseph's Home of Our Lady of Mt Carmel Inc | Skilled Nursing Facility | 9244 29th Ave, Kenosha, WI 53143-6602 | 2005-10-21 |
| 1063052488 | Elaine Romenesko | Skilled Nursing Facility | 1703 60th St, Kenosha, WI 53140-3986 | 2020-01-14 |
| 1730665159 | The Manor of Kenosha LLC | Skilled Nursing Facility | 3100 Washington Rd, Kenosha, WI 53144-1604 | 2018-07-18 |
| 1083127641 | Crossroads Care Center of Kenosha | Skilled Nursing Facility | 8633 32nd Ave, Kenosha, WI 53142-5187 | 2017-11-06 |
| 1295253045 | Nsh Kenosha LLC | Skilled Nursing Facility | 8633 32nd Ave, Kenosha, WI 53142-5187 | 2017-08-31 |
| 1700312436 | The Bay At Waters Edge Health and Rehabilitation LLC | Skilled Nursing Facility | 3415 Sheridan Rd, Kenosha, WI 53140 | 2017-05-01 |
| Find all providers in KENOSHA | ||||
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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.