United Pioneer Home, Inc
Organization Active NPI Skilled Nursing Facility · Luck, WI
NPI 1124015789 · NPPES record last updated Nov 27, 2019
Key facts
- NPI
- 1124015789
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 0450 (WI)
- Legal business name
- UNITED PIONEER HOME, INC
- Practice address
- 623 S. Second St.
Luck, WI 54853-9066 - Phone
- (715) 472-2164
- Fax
- (715) 472-2180
- NPI assigned
- Sep 29, 2005
- Organization subpart
- No
Authorized official
- Name
- Jay Archie Andress
- Title
- Nursing Home Administrator
- Phone
- (715) 472-2164
Owners & managing parties with NPI records 3
-
William G. Schultz Jr., M.D.
Practitioners 2
-
Erin E McCreary, PTA
-
Jeanine Schaar, MA, CCC-SLP
Affiliated clinicians 2
-
William G. Schultz Jr., M.D.
Medicare Care Compare: Nursing home
- Listed as
- United Pioneer Home
- Overall star rating
- ★★★★☆ 4 of 5
- Health inspections
- ★★★☆☆ 3 of 5
- Staffing
- ★★★★★ 5 of 5
- Quality measures
- ★★★☆☆ 3 of 5
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Nov 1, 2004
- Medicare certification status
- Active
- Certified beds
- 50 · 44.0 residents per day on average
- Penalties (3 years)
- 1 · fines totaling $0
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 52D0397076 | United Pioneer Home | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Skilled nursing facility certification: CCN 525680
- Legal name
- UNITED PIONEER HOME INC
- Doing business as
- OMNICARE OF CHIPPEWA FALLS
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Nov 1, 2004
- Last certification
- Jul 10, 2024
- Beds
- 50
- Ownership / control type
- Nonprofit Corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jul 2, 1965 in WI
- Enrollment address
- 623 S 2ND St
Luck, WI 54853-9070 - Nursing home name
- UNITED PIONEER HOME
All disclosed owners & managing parties 13
| Name | Role | Since | Share |
|---|---|---|---|
| Donald Prose |
Corporate Director | Jun 12, 2017 | |
| Michael Broten |
Corporate Officer | Aug 1, 2023 | |
| Jane E Quick |
Operational/Managerial Control | Feb 12, 2015 | |
| United Pioneer Home Inc |
Operational/Managerial Control | Feb 17, 2025 | |
| Trustee of the SNF | Feb 17, 2025 | ||
| Craig Adair |
Corporate Director | Jun 12, 2006 | |
| William G Schultz |
Operational/Managerial Control | Feb 15, 2015 | |
| Adp of the SNF | Feb 15, 2025 | ||
| Roeschen'S Healthcare LLC |
Operational/Managerial Control | Feb 15, 2025 | |
| Adp of the SNF | May 23, 2025 | ||
| Steve a Glaim |
Corporate Officer | Jun 28, 2016 | |
| Bruce Rowe |
Corporate Director | Jun 10, 2024 | |
| Barbara Jorgensen |
Corporate Officer | Sep 3, 2024 | |
| Jay a Andress |
Corporate Director |
Dec 5, 2018 | 100% |
| Operational/Managerial Control | Dec 5, 2018 | ||
| Adp of the SNF | Feb 18, 2026 | ||
| Sue Gilhoi |
Corporate Director | Jun 12, 2023 | |
| Dale Johnson |
Corporate Director | Feb 17, 2004 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040217000557 | WI | Part a Provider - Skilled Nursing Facility | 5092609800 | Practice locations: Luck, WI |
National Provider Directory
Locations
210 E Park Ave
Luck, WI 54853
Phone (715) 472-2164
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 0450 | WI | Yes |
Addresses
Primary practice location
623 S. Second St.
Luck, WI 54853-9066
Mailing address
623 S. Second St.
Luck, WI 54853-9066
Phone (715) 472-2164
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20157300 | Medicaid | WI |
Other providers in Luck, WI
- Dann R Rowe
- Jeanine Schaar
- School District of Luck
- Michelle Amanda Shalander
- The Physical Therapy Center, SC
All providers in Luck, WI · Skilled Nursing Facility in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 27, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.