CHRISTIAN COMMUNITY HOME OF HUDSON, INC (NPI# 1568459840) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568459840 |
| Entity Type | Organization |
| Organization Name | CHRISTIAN COMMUNITY HOME OF HUDSON, INC |
| Practice Address |
1320 Wisconsin St Hudson WI 54016-1861 |
| Practice Telephone | 7153869303 |
| Mailing Telephone | 7153869303 |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2012-01-04 |
| Authorized Official Name | MR. DAN GOODIER (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 7153814210 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 2664 | WI | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 20108600 | 05 |
| Street Address |
1320 WISCONSIN ST |
| City | HUDSON |
| State | WI |
| Zip Code | 54016-1861 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679182596 | Kristine Ostertag | Physical Medicine & Rehabilitation | 1320 Wisconsin St, Hudson, WI 54016-1861 | 2020-07-27 |
| 1790291409 | Nicole Beck | Occupational Therapist | 1320 Wisconsin St, Hudson, WI 54016-1861 | 2017-12-18 |
| 1386153310 | Tyler Joseph Gregory | Physical Therapist | 1320 Wisconsin St, Hudson, WI 54016-1861 | 2017-09-21 |
| 1215457163 | Quincy Conrad | Speech-Language Pathologist | 1320 Wisconsin St, Hudson, WI 54016-1861 | 2017-06-21 |
| 1801320205 | Sondra Becker | Physical Therapy Assistant | 1320 Wisconsin St, Hudson, WI 54016-1861 | 2017-04-12 |
| 1134662430 | Nicole Kauffmann | Occupational Therapist | 1320 Wisconsin St, Hudson, WI 54016-1861 | 2016-11-18 |
| 1861872830 | Joan Heebink | Physical Therapy Assistant | 1320 Wisconsin St, Hudson, WI 54016-1861 | 2015-06-04 |
| 1346648540 | Mary Smith | Occupational Therapy Assistant | 1320 Wisconsin St, Hudson, WI 54016-1861 | 2014-12-21 |
| 1760648661 | Deanna Rae Carey | Occupational Therapist | 1320 Wisconsin St, Hudson, WI 54016-1861 | 2008-07-31 |
| 1962677286 | Sibylle Franziska Gridley | Physical Therapist | 1320 Wisconsin St, Hudson, WI 54016-1861 | 2008-04-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164921128 | Sara Lynn Henry | Occupational Therapy Assistant | 1320 Wisconsin St., Husdon, WI 54016 | 2018-02-06 |
| 1689003436 | Serving Hands Inc | Home Health | 1419 Boulder Court, Hudson, WI 54016 | 2013-11-02 |
| 1275973042 | Lisa Renee Haverly | Occupational Therapist | 477 Perch Lake Rd, Hudson, WI 54016 | 2013-06-26 |
| 1710320213 | Emily Ann Stevenson | Counselor | 901 4th St Ste 165, Hudson, WI 54016 | 2013-04-15 |
| 1083972954 | The Shurden Group | In Home Supportive Care | 2424 Monetary Blvd. #012, The Shurden Group Dba Comfort Keepers, Hudson, WI 54016 | 2012-04-30 |
| 1124305933 | Robert Michael Catlow-price | Massage Therapist | 131 Carmichael Road, Suite #202, Hudson, WI 54016 | 2011-11-08 |
| 1962780221 | Qin Chu | Acupuncturist | 1615 Maxwell Dr., Suite D, Hudson, WI 54016 | 2011-08-03 |
| 1124324231 | Hung Trieu Lieu | Acupuncturist | 1810 Crest View Dr Ste 4a, Hudson, WI 54016 | 2011-02-07 |
| 1912214966 | Sumac Residential LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 723 B Blue Jay Lane, Hudson, WI 54016 | 2010-09-10 |
| 1740593201 | Michelle Marie Young | Counselor | 2501 Hanley Road, Suite F, Eagle Valley Bank Building, Hudson, WI 54016 | 2010-07-26 |
| Find all providers in zip 54016 | ||||
| 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 |
|---|---|---|---|---|
| 1174905087 | Aegis Therapies | Skilled Nursing Facility | 900 Colonial Dr, Hudson, WI 54016-1936 | 2015-06-26 |
| 1538578000 | Hudson Elms | Skilled Nursing Facility | 563 West Streetsboro Street, Hudson, OH 44236 | 2014-08-08 |
| 1619232337 | Hudson Health and Rehabilitation Center, Inc. | Skilled Nursing Facility | 1212 Barlow Rd, Hudson, OH 44236-3713 | 2012-07-09 |
| 1689821399 | Janet Pelletier | Skilled Nursing Facility | 46 Rangers Dr, Hudson, NH 03051-3534 | 2008-08-25 |
| 1033136858 | Health Center of Hudson Inc | Skilled Nursing Facility | 7210 Beacon Woods Dr, Hudson, FL 34667-1974 | 2006-07-16 |
| 1285679597 | Bear Creek Nursing Center, LLC | Skilled Nursing Facility | 8041 State Road 52, Hudson, FL 34667-6726 | 2006-06-19 |
| 1417997214 | Tandem Health Care of Bayonet Point, Inc. | Skilled Nursing Facility | 8132 Hudson Ave, Hudson, FL 34667-8571 | 2006-06-08 |
| 1366400103 | Hudson Health Care, Inc. | Skilled Nursing Facility | 563 W Streetsboro St, Hudson, OH 44236-2050 | 2006-05-02 |
| 1053308122 | Ward Enterprises LLP | Skilled Nursing Facility | 720 Parkway, Hudson, SD 57034 | 2005-10-04 |
| 1295728905 | Laurel Lake Retirement Community, Inc. | Skilled Nursing Facility | 200 Laurel Lake Dr, Hudson, OH 44236-2156 | 2005-08-27 |
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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.