Clearwater Care Center, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

3224 Issued in WI

Legal business name

CLEARWATER CARE CENTER, LLC

Practice address

2120 Heights Drive
Eau Claire, WI 54701

Phone

(715) 832-1681

Fax

(715) 831-7022

NPI assigned

Jun 24, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Douglass B. Smith

Title

President and Coo

Phone

(615) 647-9004

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• American Eagle Nursing Home Company of Eau Claire, LLC Former legal business name

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Putnam County Hospital

  • Pediatric Skilled Nursing Facility
  • Wabash, IN
  • NPI 1316932874

  Member Of

  NPD member

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527724800000",
    "number": "1003842873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 SOUTH WATER AVENUE",
            "city": "GALLATIN",
            "state": "TN",
            "postal_code": "370662902",
            "telephone_number": "615-989-7881",
            "fax_number": "715-831-7022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 HEIGHTS DRIVE",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "54701",
            "telephone_number": "715-832-1681",
            "fax_number": "715-831-7022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEARWATER CARE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-24",
        "last_updated": "2018-05-31",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DOUGLASS",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PRESIDENT AND COO",
        "authorized_official_telephone_number": "615-647-9004",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "3224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100007803",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "American Eagle Nursing Home Company of Eau Claire, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Mary Beth Clark, SLP
• Clear Water Home Care LLC
• Clear Water Therapy, LLC
• Clearsky Rehabilitation Hospital of Eau Claire LLC
• Clearwater Assisted Living
• Clearwater Chiropractic LLC
• Clearwater Chiropractic LLC
• Clearwater Counseling and Personal Growth Center, Inc.
• Clearwater Dental SC
• Marjorie Ann Clement, DDS

• Skilled Nursing Facility in Eau Claire, WI
• Providers in Eau Claire, WI by specialty
• Skilled Nursing Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.