NPIMap

Organization Active NPI

Harbor Beach Community Hospital Inc

  • Skilled Nursing Facility
  • Harbor Beach, MI
National Provider Identifier
1104887579
Registry record updated Feb 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
323040 Issued in MI
Legal business name
HARBOR BEACH COMMUNITY HOSPITAL INC
Practice address
210 S 1St St
Harbor Beach, MI 48441-1236
Phone
(989) 479-3201
Fax
(989) 479-5000
NPI assigned
Mar 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2026

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

Authorized official

Name
Jill Wehner
Title
President
Phone
(989) 479-5013

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 323040 MI Primary

Addresses

Primary practice location

210 S 1St St
Harbor Beach, MI 48441-1236

Mailing address

210 S 1St St
Harbor Beach, MI 48441-1236
Phone (989) 479-3201

Other identifiers 1

IdentifierTypeStateIssuer
2000331MedicaidMI

Other names 1

  • LAKEVIEW EXTENDED CARE AND REHAB Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100308000758 MI Part A Provider - Skilled Nursing Facility 7214903483 Practice locations: Harbor Beach, MI

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Skilled nursing facility certification: CCN 235295

Legal name
HARBOR BEACH COMMUNITY HOSPITAL INC
Doing business as
LAKEVIEW EXTENDED CARE AND REHAB
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 12, 1976
Last certification
Nov 20, 2024
Beds
30
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Enrollment address
210 S 1St St
Harbor Beach, MI 48441-1236
Nursing home name
LAKEVIEW EXTENDED CARE AND REHABILITATION

National Provider Directory

National Provider Directory
Tax ID family
Harbor Beach Hospital Inc14 organizations share this tax ID, including this one
Part of
Harbor Beach Hospital Inc

Other organizations with this tax ID 13

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

View all 13

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/harborb-4a958f5b

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Elias S Kabban Individual Corporate DirectorBoard Member Chairman Jan 1, 2008
Patrick McCollough Individual Corporate DirectorBoard Member Apr 27, 2011
Janet Sloan Individual Corporate DirectorBoard Member Apr 23, 2013
Ali a Khan Individual Corporate DirectorMedical Director Jun 1, 2017
Operational/Managerial Control Jun 1, 2017
Scott Rayl Individual Corporate DirectorBoard Member Apr 28, 2010
Wayne Kadar Individual Corporate DirectorBoard Member Jan 1, 2008
Jill Wehner Individual Corporate OfficerCeo Nov 20, 1999
Operational/Managerial Control Jul 1, 2023
David Hunter Individual Corporate DirectorBoard Member Jan 1, 2008
Gregory Woodke Individual Corporate DirectorBoard Member Jun 1, 2015

Owners & managing parties with NPI records 1

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

  • Ali A Khan, MD
    • Internal Medicine Physician
    • Pigeon, MI
    • NPI 1598870503

    Corporate Director, Operational/Managerial Control

    CMS ownership

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

Affiliated clinicians 1

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Lakeview Extended Care and RehabilitationCCN 235295
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
5 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Apr 12, 1976
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
3028.3 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2201299Lakeview Extended Care and Rehab210 S First Street, Harbor Beach, MI 48441Certificate of waiverNov 18, 2026

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770681600000",
    "number": "1104887579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 S 1ST ST",
            "city": "HARBOR BEACH",
            "state": "MI",
            "postal_code": "484411236",
            "telephone_number": "989-479-3201",
            "fax_number": "989-479-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 S 1ST ST",
            "city": "HARBOR BEACH",
            "state": "MI",
            "postal_code": "484411236",
            "telephone_number": "989-479-3201",
            "fax_number": "989-479-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBOR BEACH COMMUNITY HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-28",
        "last_updated": "2026-02-10",
        "certification_date": "2026-02-10",
        "status": "A",
        "authorized_official_last_name": "WEHNER",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "989-479-5013"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MI",
            "license": "323040",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2000331",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LAKEVIEW EXTENDED CARE AND REHAB",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LAKEVIEW EXTENDED CARE AND REHAB",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Harbor Beach, MI

Sources for this page

Verify at the official NPI Registry.