HEARTLAND-WASHINGTON MANOR OF KENOSHA WI LLC (NPI# 1609823723) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609823723 |
| Entity Type | Organization |
| Organization Name | HEARTLAND-WASHINGTON MANOR OF KENOSHA WI LLC |
| Other Organization Name | HEARTLAND HEALTH CARE CENTER-WASHINGTON MANOR |
| Practice Address |
3100 Washington Rd Kenosha WI 53144-1604 |
| Mailing Address |
333 N Summit St Toledo OH 43604-2615 |
| Practice Telephone | 2626584622 |
| Practice Fax Number | 2626581503 |
| Mailing Telephone | 4192525500 |
| Mailing Fax Number | 8773859446 |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2017-05-23 |
| Authorized Official Name | MR. MARTIN D ALLEN (DIRECTOR) |
| Authorized Official Telephone | 4192525734 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 3124 | WI | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 20200000 | 05 |
| Other Name | Type Code |
|---|---|
| Heartland Health Care Center-Washington Manor | Doing Business As Name - Organization |
| Street Address |
3100 WASHINGTON RD |
| City | KENOSHA |
| State | WI |
| Zip Code | 53144-1604 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255988812 | Cassandra Grant | Speech-Language Pathologist | 3100 Washington Rd, Kenosha, WI 53144-1604 | 2019-08-19 |
| 1356812408 | Matthew Lawler | Physical Therapist | 3100 Washington Rd, Kenosha, WI 53144-1604 | 2018-12-16 |
| 1073084810 | Rachel Lauren Cole | Occupational Therapist | 3100 Washington Rd, Kenosha, WI 53144-1604 | 2018-12-05 |
| 1730665159 | The Manor of Kenosha LLC | Skilled Nursing Facility | 3100 Washington Rd, Kenosha, WI 53144-1604 | 2018-07-18 |
| 1710283080 | Michelle Lynn Szmania | Occupational Therapy Assistant | 3100 Washington Rd, Kenosha, WI 53144-1604 | 2011-02-04 |
| 1376700146 | Anna Maria Santelle | Speech-Language Pathologist | 3100 Washington Rd, Kenosha, WI 53144 | 2008-05-20 |
| 1437325776 | Claudia Ann Stelter | Physical Therapist | 3100 Washington Rd, Kenosha, WI 53144-1604 | 2008-05-06 |
| 1518132414 | Amy Lynn Renzoni | Physical Therapy Assistant | 3100 Washington Rd, Kenosha, WI 53144-1604 | 2008-04-23 |
| 1083889976 | Jill Marie Fonk | Occupational Therapist | 3100 Washington Rd, Kenosha, WI 53144-1604 | 2008-04-23 |
| 1831363563 | Valarie Lee Hess | Occupational Therapist | 3100 Washington Rd, Kenosha, WI 53144-1604 | 2008-04-14 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902410202 | Dpt Holdings LLC | Occupational Therapist | 3825 39th Ave #110, Kenosha, WI 53144 | 2020-09-03 |
| 1225641392 | Eunice Boatin | Social Worker | Kenosha Human Development Services, 3536 52nd Street, Kenosha, WI 53144 | 2020-08-28 |
| 1881250256 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 3621 Market Lane, Kenosha, WI 53144 | 2019-05-11 |
| 1124540067 | Kaitlyn King | Speech-Language Pathologist | 5219 88th Ave., Kenosha, WI 53144 | 2017-07-12 |
| 1174992721 | Claire Ann Adams | Acupuncturist | 5416 52nd Street, Kenosha, WI 53144 | 2015-09-24 |
| 1285017087 | Jessica Lynn Gillengerten | Acupuncturist | 4235 Green Bay Rd., Suite #10, Kenosha, WI 53144 | 2015-06-30 |
| 1750704656 | Amanda Kay Kreuzer | Occupational Therapy Assistant | 3109 30th Ave, Kenosha, WI 53144 | 2014-01-28 |
| 1841626785 | B7 Pharmacy Inc | Pharmacy | 3825 39th Ave Ste 100, Kenosha, WI 53144 | 2013-09-24 |
| 1124326764 | Wisconsin Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3710 57th Ave, Kenosha, WI 53144 | 2011-03-07 |
| 1982931291 | Roman Bilak | General Practice | 4126 - 7th Street, Kemosha, WI 53144 | 2009-11-06 |
| Find all providers in zip 53144 | ||||
| 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 |
| 1922179597 | Extendicare Homes, Inc. | Skilled Nursing Facility | 8633 32nd Ave, Kenosha, WI 53142-5187 | 2006-11-13 |
| 1992752380 | Beverly Enterprises - Wisconsin Inc | Skilled Nursing Facility | 1703 60th St, Kenosha, WI 53140-3986 | 2006-05-30 |
| 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 |
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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.