Extendicare Health Facilities, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

EXTENDICARE HEALTH FACILITIES, INC.

Doing business as

Monroe Manor Nursing & Rehabilitation Center

Practice address

516 26TH Ave
Monroe, WI 53566-1531

Phone

(608) 325-9141

Fax

(608) 329-6594

NPI assigned

Nov 15, 2006

Last updated

Apr 7, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Donna Jo Maassen

Title

Director of Compliance

Phone

(414) 908-8119

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Monroe Manor Nursing & Rehabilitation Center Doing business as

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207526400000",
    "number": "1023180734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W MICHIGAN ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532032903",
            "telephone_number": "414-908-8119",
            "fax_number": "414-908-7105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 26TH AVE",
            "city": "MONROE",
            "state": "WI",
            "postal_code": "535661531",
            "telephone_number": "608-325-9141",
            "fax_number": "608-329-6594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXTENDICARE HEALTH FACILITIES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2008-04-07",
        "status": "A",
        "authorized_official_last_name": "MAASSEN",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "DIRECTOR OF COMPLIANCE",
        "authorized_official_telephone_number": "414-908-8119"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20155600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Monroe Manor Nursing & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• David Allan Emmerich, O.D.
• Sarah C. Endsley, PA-C
• Jan Eberly Erlandson, MD
• Priscila Espinoza Castillo
• Vicki B Evenson, RN
• Terry R Faith, M.S. CCC-SLP
• Stephanie A. Falligant, CRNA
• Family Chiropractic Clinic of Monroe,S.C.
• Sharon M Farrey, LCSW
• Michelle S. Faull, DO

• Skilled Nursing Facility in Monroe, WI
• Providers in Monroe, 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 Apr 7, 2008; 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.