SCAL OF HOBART, LLC (NPI# 1568810422) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568810422 |
| Entity Type | Organization |
| Organization Name | SCAL OF HOBART, LLC |
| Other Organization Name | EMERALD RIDGE ASSISTED LIVING |
| Practice Address |
650 Centennial Centre Blvd Hobart WI 54155-8989 |
| Mailing Address |
3232 N Ballard Rd Suite 202 Appleton WI 54911-8804 |
| Practice Telephone | 9205445041 |
| Practice Fax Number | 9205440857 |
| Mailing Telephone | 9205743833 |
| Mailing Fax Number | 9205743850 |
| Enumeration Date | 2016-06-01 |
| Last Update Date | 2016-06-01 |
| Authorized Official Name | MS. KATHERINE R. TEGEN (MANAGER) |
| Authorized Official Telephone | 9203781913 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | WI | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Emerald Ridge Assisted Living | Doing Business As Name - Organization |
| Street Address |
650 CENTENNIAL CENTRE BLVD |
| City | HOBART |
| State | WI |
| Zip Code | 54155-8989 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225317795 | Ann Marie Wells | Nurse Practitioner | 525 Airport Dr., Oneida, WI 54155 | 2011-08-15 |
| 1255363156 | Edward S Polzin | Dentist | 525 Airport Rd, Oneida, WI 54155 | 2006-07-07 |
| 1316979248 | Megan Hotchkiss | Physician Assistant | 2500 E Capitol Drive, Suite 3700, Appleton, WI 54155 | 2006-07-07 |
| 1215911706 | Oneida Community Health Center | Durable Medical Equipment & Medical Supplies | 525 Airprort Rd, Oneida, WI 54155 | 2005-11-30 |
| 1528322849 | Dianna Langner | Nurse Practitioner | 525 Airport Dr, Oneida, WI 54155 | 2012-07-02 |
| 1841556446 | Alyssa J Hudak | Dietitian, Registered | 525 Airport Rd, Oneida, WI 54155 | 2012-04-09 |
| 1780633669 | Ravinder Vir | Internal Medicine | 525 Airport Dr, Oneida, WI 54155 | 2006-05-09 |
| 1891165635 | Elizabeth Kelley | Counselor | Po Box 365, Oneida, WI 54155-0365 | 2015-10-06 |
| 1417488289 | Kimberly Damrow | Dietitian, Registered | 525 Airport Drive, Oneida, WI 54155-0935 | 2017-03-23 |
| 1891192803 | Yvonne White | Dentist | 525 Airport Rd, Oneida, WI 54155-0935 | 2014-11-20 |
| Find all providers in zip 54155 | ||||
| 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 |
|---|---|---|---|---|
| 1568799138 | Summerville 2, LLC | Assisted Living Facility | 1147 South 3rd Street, Hobart, IN 46342-4956 | 2009-11-03 |
| 1083094726 | Gahc3 Hobart In Alf Trs Sub, LLC | Assisted Living Facility | 1420 Saint Marys Cir, Hobart, IN 46342-6561 | 2015-06-08 |
| 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.