Lake Mills Ia Skilled Nursing Facility, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

LAKE MILLS IA SKILLED NURSING FACILITY, LLC

Practice address

406 S 10TH Ave E
Lake Mills, IA 50450-1851

Phone

(641) 592-4900

NPI assigned

Nov 22, 2023

Last updated

Nov 22, 2023By 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

Chaim Rajchenbach

Title

Principal

Phone

(847) 745-7000

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1063287746. Details of each certification follow.

• CCN 165366 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 165366

Legal name

LAKE MILLS IA SKILLED NURSING FACILITY LLC

Doing business as

LAKE MILLS CARE CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Oct 1, 1997

Last certification

Apr 9, 2025

Beds

61

Ownership / control type

Corporation

Multi-facility organization

Legacy Healthcare

Organization structure

LLCProprietary

Enrollment address

406 S 10TH Ave E
Lake Mills, IA 50450-1851

Nursing home name

LAKE MILLS CARE CENTER

Affiliated entity

LEGACY HEALTHCARE

Listed as

Lake Mills Care CenterCCN 165366 · All quality measures

Overall star rating

4 of 5

Health inspections

3 of 5

Staffing

3 of 5

Quality measures

5 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Oct 1, 1997

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

6141.1 residents per day on average

Chain

Legacy Healthcare89 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Tax ID family

Lake Mills Ia Skilled Nursing Facility LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Lake Mills Ia Skilled Nursing Facility, LLC

  • Assisted Living Facility
  • Lake Mills, IA
  • NPI 1356116099
  NPD tax ID
• Lake Mills Ia Skilled Nursing Facility, LLC

  • In Home Supportive Care Agency
  • Lake Mills, IA
  • NPI 1831929348
  NPD tax ID

All disclosed owners & managing parties 43

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Brittany Waletzko Bartz, DO

  • Family Medicine Physician
  • Blue Earth, MN
  • NPI 1184159014

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Facilities with the same owner 89

Facilities that share an organizational owner with 5% or greater ownership or operational control.

• Allison Ia Skilled Nursing Facility, LLC

  • Skilled Nursing Facility
  • Allison, IA
  • NPI 1538934229

  Legacy Healthcare Financial Services LLC

  CMS ownership
• Aplington Ia Skilled Nursing Facility, LLC

  • Skilled Nursing Facility
  • Aplington, IA
  • NPI 1326813015

  Doros Generation Trust U/a/D 1/3/12, GPN Family Trust U/a/D 4/28/08, Iowa Portfolio Opco Holdings LLC, Legacy Healthcare Financial Services LLC, Oakway Operations LLC

  CMS ownership
• Armstrong Ia Skilled Nursing Facility, LLC

  • Skilled Nursing Facility
  • Armstrong, IA
  • NPI 1316712011

  GPN Family Trust U/a/D 4/28/08, Iowa Portfolio Opco Holdings LLC, Legacy Healthcare Financial Services LLC

  CMS ownership
• Battle Creek Ia Skilled Nursing Facility, LLC

  • Skilled Nursing Facility
  • Battle Creek, IA
  • NPI 1487429189

  Doros Generation Trust U/a/D 1/3/12, GPN Family Trust U/a/D 4/28/08, Iowa Portfolio Opco Holdings LLC, Legacy Healthcare Financial Services LLC, Oakway Operations LLC

  CMS ownership
• Belmond Ia Skilled Nursing Facility, LLC

  • Skilled Nursing Facility
  • Belmond, IA
  • NPI 1982479671

  GPN Family Trust U/a/D 4/28/08, Iowa Portfolio Opco Holdings LLC, Legacy Healthcare Financial Services LLC

  CMS ownership
• Bloomfield Ia Skilled Nursing Facility LLC

  • Skilled Nursing Facility
  • Bloomfield, IA
  • NPI 1093580821

  Doros Generation Trust U/a/D 1/3/12, GPN Family Trust U/a/D 4/28/08, Iowa Portfolio Opco Holdings LLC, Legacy Healthcare Financial Services LLC, Oakway Operations LLC

  CMS ownership
• Britt Ia Skilled Nursing Facility, LLC

  • Skilled Nursing Facility
  • Britt, IA
  • NPI 1851166557

  Doros Generation Trust U/a/D 1/3/12, GPN Family Trust U/a/D 4/28/08, Iowa Portfolio Opco Holdings LLC, Legacy Healthcare Financial Services LLC, Oakway Operations LLC

  CMS ownership
• Cedar Rapids Skilled Nursing Facility LLC

  dba Harmony Cedar Rapids

  • Skilled Nursing Facility
  • Cedar Rapids, IA
  • NPI 1699489385

  Doros Generation Trust U/a/D 1/3/12, GPN Family Trust U/a/D 4/28/08, Legacy Healthcare Financial Services LLC, Oakway Operations LLC

  CMS ownership
• Clear Lake Ia Skilled Nursing Facility, LLC

  • Skilled Nursing Facility
  • Clear Lake, IA
  • NPI 1114792801

  Legacy Healthcare Financial Services LLC

  CMS ownership
• Davenport Skilled Nursing Facility LLC

  dba Harmony Davenport

  • Skilled Nursing Facility
  • Davenport, IA
  • NPI 1780398842

  Doros Generation Trust U/a/D 1/3/12, GPN Family Trust U/a/D 4/28/08, Legacy Healthcare Financial Services LLC, Oakway Operations LLC

  CMS ownership
• Des Moines Skilled Nursing Facility LLC

  dba Harmony West Des Moines

  • Skilled Nursing Facility
  • West Des Moines, IA
  • NPI 1861106924

  Doros Generation Trust U/a/D 1/3/12, GPN Family Trust U/a/D 4/28/08, Legacy Healthcare Financial Services LLC, Oakway Operations LLC

  CMS ownership
• Dubuque Skilled Nursing Facility LLC

  dba Harmony Dubuque

  • Skilled Nursing Facility
  • Dubuque, IA
  • NPI 1104530286

  Doros Generation Trust U/a/D 1/3/12, GPN Family Trust U/a/D 4/28/08, Legacy Healthcare Financial Services LLC, Oakway Operations LLC

  CMS ownership

Affiliated clinicians 4

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• John Brady, DO

  • Family Medicine Physician
  • Clear Lake, IA
  • NPI 1154382513

  Nursing home

  Care Compare affiliation
• Anna Ruth Holzer, MD

  • Family Medicine Physician
  • Altoona, IA
  • NPI 1457664799

  Nursing home

  Care Compare affiliation
• John Andrew Grzybowski, M.D.

  • Family Medicine Physician
  • Albert Lea, MN
  • NPI 1679552038

  Nursing home

  Care Compare affiliation
• Brittany Waletzko Bartz, DO

  • Family Medicine Physician
  • Blue Earth, MN
  • NPI 1184159014

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1700611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700611200000",
    "number": "1063287746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 S 10TH AVE E",
            "city": "LAKE MILLS",
            "state": "IA",
            "postal_code": "504501851",
            "telephone_number": "641-592-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 S 10TH AVE E",
            "city": "LAKE MILLS",
            "state": "IA",
            "postal_code": "504501851",
            "telephone_number": "641-592-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE MILLS IA SKILLED NURSING FACILITY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-22",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A",
        "authorized_official_last_name": "RAJCHENBACH",
        "authorized_official_first_name": "CHAIM",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "847-745-7000"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keith A. Johnson, DDS
• Keith a. Johnson, DDS, PC
• Lake Mills Ambulance Service
• Lake Mills Community School
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• Lake Mills Ia Skilled Nursing Facility, LLC
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• Lake Mills Pharmacy Inc (Redinger Pharmacy)
• Lake Mills Physical Therapy LLC
• John Dale Leegaard

• Skilled Nursing Facility in Lake Mills, IA
• Providers in Lake Mills, IA by specialty
• Skilled Nursing Facility in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.