EXTENDICARE HOMES, INC. (NPI# 1811061427) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811061427 |
| Entity Type | Organization |
| Organization Name | EXTENDICARE HOMES, INC. |
| Other Organization Name | PROFESSIONAL CARE REHABILITATION CENTER |
| Practice Address |
404 West Willow Road Dale IN 47523 |
| Mailing Address |
111 W Michigan St Milwaukee WI 53203-2903 |
| Practice Telephone | 8129374489 |
| Practice Fax Number | 8129377101 |
| Mailing Telephone | 4149088119 |
| Mailing Fax Number | 4149087105 |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DONNA JO MAASSEN (DIRECTOR OF COMPLIANCE) |
| Authorized Official Telephone | 4149088119 |
| 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 |
|---|---|
| Professional Care Rehabilitation Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740345800 | Extendicare Homes, Inc. | Assisted Living Facility | 100 E Dalke Ave, Spokane, WA 99208-1006 | 2006-12-27 |
| 1639245558 | Extendicare Homes, Inc. | Skilled Nursing Facility | 1902 Mead Ave, Sheboygan, WI 53081-6140 | 2006-11-24 |
| 1912070624 | Extendicare Homes, Inc. | Skilled Nursing Facility | 414 Robey St, Franklin, KY 42134-1034 | 2006-11-17 |
| 1043383771 | Extendicare Homes, Inc. | Skilled Nursing Facility | 2500 N Elm St, Henderson, KY 42420-2005 | 2006-11-17 |
| 1790859486 | Extendicare Homes, Inc. | Skilled Nursing Facility | 3431 N 13th St, Sheboygan, WI 53083-2938 | 2006-11-17 |
| 1871666560 | Extendicare Homes, Inc. | Skilled Nursing Facility | 1561 Newton Ave, Bowling Green, KY 42104-3238 | 2006-11-17 |
| 1215001862 | Extendicare Homes, Inc. | Skilled Nursing Facility | 619 W Walnut St, Milwaukee, WI 53212-3839 | 2006-11-17 |
| 1619041340 | Extendicare Homes, Inc. | Skilled Nursing Facility | 867 Mcguire Ave, Paducah, KY 42001-4036 | 2006-11-17 |
| 1255405700 | Extendicare Homes, Inc. | Skilled Nursing Facility | 2582 Cerulean Rd, Cadiz, KY 42211-9605 | 2006-11-17 |
| 1376617837 | Extendicare Homes, Inc. | Skilled Nursing Facility | 420 E Grundy Ave, Springfield, KY 40069-1173 | 2006-11-17 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | EXTENDICARE HOMES, INC. | 3500 Lenox Road Ne, Suite 510, Atlanta, GA 30326 |
| Washington State Corporations | EXTENDICARE HOMES, INC. | 3500 Lenox Rd Ne, Suite 510, Atlanta, GA 30326-4229 |
| Street Address |
404 WEST WILLOW ROAD |
| City | DALE |
| State | IN |
| Zip Code | 47523 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295934206 | Deborah Konerding | Physical Therapy Assistant | 404 West Willow Road, Dale, IN 47550 | 2007-07-11 |
| 1982802682 | Les John Kiesel | Occupational Therapist | 404 West Willow Road, Dale, IN 47523 | 2007-07-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730348772 | Theresa Harney | Day Training/Habilitation Specialist | 17049 N State Road 245, Dale, IN 47523 | 2008-06-05 |
| 1144427337 | Rachel Marie Roy | Occupational Therapist | 404 West Willow Rd, Dale, IN 47523 | 2007-06-29 |
| 1407974421 | Joseph H Antonini | Dentist | 421 West Medcalf St, Dale, IN 47523 | 2007-03-27 |
| 1427155803 | David Fisher | Dentist | 110 W. Hammond St., Dale, IN 47523 | 2006-09-20 |
| 1548770613 | Turner Rx Inc | Pharmacy | 702 Buffaloville Rd, Dale, IN 47523 | 2017-10-03 |
| 1386990109 | The Health and Hospital Corporation of Marion County | Skilled Nursing Facility | 404 W Willow Rd, Dale, IN 47523 | 2012-07-30 |
| 1063610483 | Stacy Marie George | Speech-Language Pathologist | 404 West Willow Rd, Dale, IN 47523 | 2007-07-06 |
| 1578761144 | Ashraf Jewell | Physical Therapy Assistant | 404 West Willow Rd, Dale, IN 47523 | 2007-07-05 |
| 1174603153 | Little Company of Mary Hospital of Indiana Inc | Clinic/Center | 4 W Vine St, Dale, IN 47523 | 2006-10-16 |
| 1467509463 | Major Hospital | Skilled Nursing Facility | 510 W Medcalf, Box 325, Dale, IN 47523-0325 | 2007-01-04 |
| Find all providers in zip 47523 | ||||
| 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 |
|---|---|---|---|---|
| 1467509463 | Major Hospital | Skilled Nursing Facility | 510 W Medcalf, Box 325, Dale, IN 47523-0325 | 2007-01-04 |
| 1386990109 | The Health and Hospital Corporation of Marion County | Skilled Nursing Facility | 404 W Willow Rd, Dale, IN 47523 | 2012-07-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023618956 | Empowerme Rehabilitation Illinois, LLC | Skilled Nursing Facility | 3203 E Moores Pike, Bloomington, IN 47401-7122 | 2020-10-29 |
| 1629698808 | Decatur County Memorial Hospital | Skilled Nursing Facility | 6712 Restoracy Drive, Whitestown, IN 46075-0089 | 2020-04-17 |
| 1922586510 | Aperion Care Marion LLC | Skilled Nursing Facility | 614 W 14th St, Marion, IN 46953-2158 | 2018-08-06 |
| 1427548270 | Vibra Rehabilitation Hospital of Southern Indiana, LLC | Skilled Nursing Facility | 3104 Blackiston Boulevard, New Albany, IN 47150-9579 | 2018-05-17 |
| 1952812034 | Blue Diamond Villas | Skilled Nursing Facility | 1510 Sandpiper Lane, Goshen, IN 46526 | 2017-10-17 |
| 1366974404 | Mika Riddle | Skilled Nursing Facility | 407 W Walnut St, Van Buren, IN 46991 | 2017-03-29 |
| 1245787076 | Sara Steffe | Skilled Nursing Facility | 1015 Virginia St, Ferdinand, IN 47532-9285 | 2016-09-09 |
| 1770030504 | Valerie Burdette | Skilled Nursing Facility | 1872 E County Road 825 S, Oakland City, IN 47660-8911 | 2016-09-09 |
| 1205286507 | Christina Basham | Skilled Nursing Facility | 710 Bluffview Dr, Angola, IN 46703-2206 | 2016-06-16 |
| 1164878583 | Good Samaritan Hospital | Skilled Nursing Facility | 811 E. Baseline Road, Evansville, IN 47725-9340 | 2016-05-05 |
| 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.