CROSSROADS CARE CENTER OF FOND DU LAC LLC (NPI# 1972016533) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972016533 |
| Entity Type | Organization |
| Organization Name | CROSSROADS CARE CENTER OF FOND DU LAC LLC |
| Practice Address |
115 E Arndt St Fond Du Lac WI 54935-2461 |
| Mailing Address |
8150 Central Park Ave Skokie IL 60076-2974 |
| Practice Telephone | 9209237040 |
| Mailing Telephone | 8479834860 |
| Enumeration Date | 2017-11-06 |
| Last Update Date | 2018-01-23 |
| Authorized Official Name | DAVID MERZEL (CFO) |
| Authorized Official Telephone | 8479834860 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| Street Address |
115 E ARNDT ST |
| City | FOND DU LAC |
| State | WI |
| Zip Code | 54935-2461 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467419218 | Julie Meincke | Occupational Therapist | 115 E Arndt St, Fond Du Lac, WI 54935-2461 | 2006-04-26 |
| 1790383891 | Lisa Simanek | Occupational Therapist | 115 E Arndt St, Fond Du Lac, WI 54935-2461 | 2020-10-12 |
| 1730798182 | Brittany Ann Soboleski | Speech-Language Pathologist | 115 E Arndt St, Fond Du Lac, WI 54935-2461 | 2020-07-30 |
| 1538719398 | See Yang | Occupational Therapy Assistant | 115 E Arndt St, Fond Du Lac, WI 54935-2461 | 2019-09-13 |
| 1164075883 | Monica Garvey Krueger | Speech-Language Pathologist | 115 E Arndt St, Fond Du Lac, WI 54935-2461 | 2019-07-22 |
| 1013435536 | Nsh Fond Du Lac LLC | Skilled Nursing Facility | 115 E Arndt St, Fond Du Lac, WI 54935-2461 | 2017-09-05 |
| 1891218418 | Stephanie Nicole Fry | Occupational Therapist | 115 E Arndt St, Fond Du Lac, WI 54935-2461 | 2017-07-25 |
| 1972035186 | Christina Louise Kanuscak | Occupational Therapy Assistant | 115 E Arndt St, Fond Du Lac, WI 54935-2461 | 2017-03-28 |
| 1659733889 | Hanh Vogds | Occupational Therapy Assistant | 115 E Arndt St, Fond Du Lac, WI 54935-2461 | 2016-03-26 |
| 1386033181 | Fmg East Arndt Street Wisconsin LLC | Skilled Nursing Facility | 115 E Arndt St, Fond Du Lac, WI 54935-2461 | 2015-01-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609482249 | Keziah Sherri Love | Counselor | W390 Wi-23, Fond Du Lac, WI 54935 | 2020-09-18 |
| 1891341988 | Cynthia Louise Singleton | Nurse Practitioner | 16 E 13th St., Fond Du Lac, WI 54935 | 2019-08-14 |
| 1083183297 | Elena Alexandra Giese | Nurse Practitioner | 430 E. Division St, Fond Du Lac, WI 54935 | 2018-11-16 |
| 1669963740 | Elizabeth Anne Machi | Student in an Organized Health Care Education/Training Program | 885 Western Ave Ste 300, Fond Du Lac, WI 54935 | 2018-05-23 |
| 1184150021 | Jordan Moehn | Specialist/Technologist | 633 Prairie Pkwy, Fond Du Lac, WI 54935 | 2017-05-11 |
| 1467856336 | Chuentao Ho | Specialist/Technologist | 45 South National Ave., Fond Du Lac, WI 54935 | 2014-10-21 |
| 1437587961 | Paula Seeley | Nurse Practitioner | 63 West Pioneer Rd, Fond Du Lac, WI 54935 | 2013-10-18 |
| 1144516030 | Bonnie Kay Mallon | Registered Nurse | 118 E 9th St, Fond Du Lac, WI 54935 | 2011-06-20 |
| 1770885600 | Holly Shepard | Counselor | 23 W Scott St., Fond Du Lac, WI 54935 | 2010-11-29 |
| 1437479110 | Ruth Marie Bohn | Occupational Therapy Assistant | 244 North Macy Street, Fond Du Lac, WI 54935 | 2010-06-04 |
| Find all providers in zip 54935 | ||||
| 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 |
|---|---|---|---|---|
| 1003951468 | Fond Du Lac County | Skilled Nursing Facility | 459 East First Street, Fond Du Lac, WI 54935-4505 | 2007-02-21 |
| 1730135179 | Manor Care of Fond Du Lac Wi LLC | Skilled Nursing Facility | 265 S National Ave, Fond Du Lac, WI 54935-5334 | 2006-05-26 |
| 1659358323 | Fond Du Lac County | Skilled Nursing Facility | 459 E 1st St, Fond Du Lac, WI 54935-4505 | 2005-12-23 |
| 1295721991 | Grancare Inc | Skilled Nursing Facility | 517 E Division St, Fond Du Lac, WI 54935-3735 | 2005-09-27 |
| 1316422025 | Fond Du Lac Nursing and Rehab, LLC | Skilled Nursing Facility | 265 S National Ave, Fond Du Lac, WI 54935-5334 | 2018-09-27 |
| 1972089399 | Ccc of East Fond Du Lac | Skilled Nursing Facility | 265 S National Ave, Fond Du Lac, WI 54935-5334 | 2018-07-18 |
| 1013435536 | Nsh Fond Du Lac LLC | Skilled Nursing Facility | 115 E Arndt St, Fond Du Lac, WI 54935-2461 | 2017-09-05 |
| 1750821153 | Golden High LLC | Skilled Nursing Facility | 517 E Division St, Fond Du Lac, WI 54935-3735 | 2017-03-03 |
| 1386033181 | Fmg East Arndt Street Wisconsin LLC | Skilled Nursing Facility | 115 E Arndt St, Fond Du Lac, WI 54935-2461 | 2015-01-16 |
| 1861667248 | Hcr Manor Care | Skilled Nursing Facility | 265 S National Ave, Fond Du Lac, WI 54935-5334 | 2008-04-25 |
| Find all providers in FOND DU LAC | ||||
| City | FOND DU LAC |
| Zip Code | 54935 |
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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.