WOODS OF CALEDONIA MEMORY CARE LLC (NPI# 1932700994) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932700994 |
| Entity Type | Organization |
| Organization Name | WOODS OF CALEDONIA MEMORY CARE LLC |
| Practice Address |
5737 Erie St Racine WI 53402-1970 |
| Mailing Address |
8170 Mccormick Blvd Ste 112 Skokie IL 60076-2914 |
| Practice Telephone | 2624177120 |
| Mailing Telephone | 7738192190 |
| Enumeration Date | 2020-11-05 |
| Last Update Date | 2020-11-05 |
| Authorized Official Name | PAMELA RICE (DIRECTOR OF REVENUE) |
| Authorized Official Telephone | 8477128901 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Woods of Caledonia | Former Legal Business Name - Organization |
| Street Address |
5737 ERIE ST |
| City | RACINE |
| State | WI |
| Zip Code | 53402-1970 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851990436 | Bv/mstar Caledonia Tenant, LLC | Alzheimer Center (Dementia Center) | 5737 Erie St, Racine, WI 53402-1970 | 2020-10-23 |
| 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 | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194345942 | Platinum Communities - Racine LLC | Assisted Living Facility | 3950 N Main St, Racine, WI 53402-3683 | 2020-04-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326654534 | Praitie Assisted Living Inc. | Assisted Living Facility | 749 E Oshkosh St, Ripon, WI 54971-1258 | 2020-09-22 |
| 1295340016 | St. Elizabeth Manor, Inc. | Assisted Living Facility | 111 Commercial Dr, Footville, WI 53537 | 2020-09-09 |
| 1730793001 | Zinzendorf Hall, Inc. | Assisted Living Facility | 1047 Hill St, Watertown, WI 53098-3015 | 2020-09-03 |
| 1184236044 | Francine Carter | Assisted Living Facility | 4341 N 19th St, Milwaukee, WI 53209-6831 | 2020-08-20 |
| 1598377905 | Nohc Jackson Senior Living LLC | Assisted Living Facility | N16744 Eagle Drive, Jackson, WI 53037 | 2020-08-18 |
| 1003427766 | Nohc Magnolia Meadows LLC | Assisted Living Facility | 1480 N 7th St, Manitowoc, WI 54220-2012 | 2020-08-14 |
| 1922616580 | Rheuvonia Reed | Assisted Living Facility | 543 E Arbor Cir, Oak Creek, WI 53154-8528 | 2020-07-20 |
| 1912515073 | Baldwin Coh, LLC | Assisted Living Facility | 1880 4th Ave, Baldwin, WI 54002-5134 | 2020-07-15 |
| 1427666593 | Hudson Coh II, LLC | Assisted Living Facility | 805 Heggen St, Hudson, WI 54016-5005 | 2020-07-15 |
| 1366050429 | Hudson Coh, LLC | Assisted Living Facility | 1111 Heggen St, Hudson, WI 54016-9222 | 2020-07-15 |
| 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.