EASTSIDE OPERATING COMPANY LLC (NPI# 1538497060) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538497060 |
| Entity Type | Organization |
| Organization Name | EASTSIDE OPERATING COMPANY LLC |
| Other Organization Name | LAKE TERRACE HEALTH AND REHABILITATION |
| Practice Address |
2115 E Woodstock Pl Milwaukee WI 53202-1342 |
| Mailing Address |
1423 Clarkview Rd Suite 500 Baltimore MD 21209-2134 |
| Practice Telephone | 4103423155 |
| Mailing Telephone | 4104272700 |
| Mailing Fax Number | 4148155558 |
| Enumeration Date | 2009-11-20 |
| Last Update Date | 2015-06-10 |
| Authorized Official Name | MR. BRIAN K. REYNOLDS (MANAGER) |
| Authorized Official Telephone | 4105138738 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Lake Terrace Health and Rehabilitation | Doing Business As Name - Organization |
| Street Address |
2115 E WOODSTOCK PL |
| City | MILWAUKEE |
| State | WI |
| Zip Code | 53202-1342 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215092184 | Delphi Healthcare LLC | Skilled Nursing Facility | 2115 E Woodstock Pl, Milwaukee, WI 53202-1342 | 2006-12-22 |
| 1366097206 | Noelle Corinne Linden | Physical Therapist | 2115 E Woodstock Pl, Milwaukee, WI 53202-1342 | 2019-08-07 |
| 1053803031 | Lake Terrace Nursing and Rehab LLC | Skilled Nursing Facility | 2115 E Woodstock Pl, Milwaukee, WI 53202-1342 | 2018-06-05 |
| 1831609023 | Andjelka Bogunovic | Occupational Therapist | 2115 E Woodstock Pl, Milwaukee, WI 53202-1342 | 2017-10-03 |
| 1821549577 | Julie Shmidheiser | Occupational Therapist | 2115 E Woodstock Pl, Milwaukee, WI 53202 | 2016-10-18 |
| 1568853273 | Mary Zignego | Physical Therapy Assistant | 2115 E Woodstock Pl, Milwaukee, WI 53202-1342 | 2015-02-17 |
| 1003254418 | Melissa Brook | Occupational Therapist | 2115 E Woodstock Pl, Milwaukee, WI 53202-1342 | 2013-06-07 |
| 1922365667 | Angeline Dao | Occupational Therapist | 2115 E Woodstock Pl, Milwaukee, WI 53202-1342 | 2012-04-19 |
| 1417263948 | Arti Berry | Occupational Therapist | 2115 E Woodstock Pl, Milwaukee, WI 53202-1342 | 2010-08-22 |
| 1356663520 | Keri Mckeough | Speech-Language Pathologist | 2115 E Woodstock Pl, Milwaukee, WI 53202-1342 | 2010-02-16 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053958298 | Melanie Ann Pare | Occupational Therapist | 1414 N. Prospect Ave., Milwaukee, WI 53202 | 2019-12-06 |
| 1568921278 | Sword Health Inc | Health Educator | 1020 North Broadway, Milwaukee, WI 53202 | 2019-03-13 |
| 1619446408 | First Priority Home Care, LLC | Home Health | 342 W. Water Street, Suite 600, Milwaukee, WI 53202 | 2018-11-21 |
| 1346747169 | Creative Counseling of Milwaukee | Counselor | 2266 E Prospect Ave, Suite 304, Milwaukee, WI 53202 | 2018-04-09 |
| 1043692700 | Matthew Weinlander | Psychiatry & Neurology | 827 N Cass St # 9, Milwaukee, WI 53202 | 2015-06-18 |
| 1437572831 | Pathfinder Medical Group | Family Medicine | 216 Milwaukee St, Suite 2d, Milwaukee, WI 53202 | 2014-01-22 |
| 1669819785 | Kate Savage Anzia | Counselor | 2266 North Prospect Avenue, Suite 326, Ravenswood Clinic, Milwaukee, WI 53202 | 2013-05-30 |
| 1164773222 | Rutell Counseling Services, L.L.C. | Counselor | 759 N. Milwaukee St., Suite 600, Milwaukee, WI 53202 | 2012-09-28 |
| 1548563760 | Susan Rose Westergren | Pharmacist | 1400 E. Brady St, Walgreens, Milwaukee, WI 53202 | 2010-12-09 |
| 1174848816 | Brian D Eiche | Emergency Medicine | 111 E. Wisconsin Ave. Ste 2100, Infinity Healthcare, Milwaukee, WI 53202 | 2010-04-06 |
| Find all providers in zip 53202 | ||||
| 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 |
|---|---|---|---|---|
| 1780079046 | Rivershore Clinic | Skilled Nursing Facility | 3707 N. Richards St., Milwaukee Health Service, Milwaukee, WI 53212-1673 | 2015-04-03 |
| 1184943540 | Heavenly Touch Nursing | Skilled Nursing Facility | 5606 N 94th St, Milwaukee, WI 53225-2602 | 2010-05-25 |
| 1962731331 | Highland Heights | Skilled Nursing Facility | 2816 N 49th St, Milwaukee, WI 53210-1651 | 2009-12-15 |
| 1427385038 | Marys Adult Family Services LLC | Skilled Nursing Facility | 2802 N 40th St, Suite 210, Milwaukee, WI 53210-1806 | 2009-11-03 |
| 1649464645 | Independent Nurse | Skilled Nursing Facility | 1919 N 19th St, Milwaukee, WI 53205-1547 | 2007-09-02 |
| 1740482181 | Diane L Weidner | Skilled Nursing Facility | 190 W Allerton Ave, Milwaukee, WI 53207-4910 | 2007-06-05 |
| 1235355967 | Dominican Sisters Corp. St Ann Rest Home | Skilled Nursing Facility | 2020 S Muskego Ave, Milwaukee, WI 53204-3622 | 2007-04-18 |
| 1295866325 | Saint John's Communities, Inc. | Skilled Nursing Facility | 1840 N Prospect Ave, Milwaukee, WI 53202-1975 | 2007-03-08 |
| 1578612081 | Cameo Care Center Inc. | Skilled Nursing Facility | 5790 S 27th St, Milwaukee, WI 53221-4129 | 2007-01-10 |
| 1215092184 | Delphi Healthcare LLC | Skilled Nursing Facility | 2115 E Woodstock Pl, Milwaukee, WI 53202-1342 | 2006-12-22 |
| Find all providers in MILWAUKEE | ||||
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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.