NPIMap

Organization Active NPI

Rice Lake Rehabilitation and Nursing Center LLC

Doing business as Dove Healthcare - Rice Lake

  • Skilled Nursing Facility
  • Rice Lake, WI
National Provider Identifier
1205600897
Registry record updated Nov 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
RICE LAKE REHABILITATION AND NURSING CENTER LLC
Doing business as
Dove Healthcare - Rice Lake
Practice address
910 Bear Paw Ave
Rice Lake, WI 54868-1388
Phone
(715) 234-2604
NPI assigned
Nov 14, 2023
Last updated
Nov 14, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2023

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

Authorized official

Name
Isaak Markovits
Title
Managing Member
Phone
(608) 448-6200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X NU Primary

Addresses

Primary practice location

910 Bear Paw Ave
Rice Lake, WI 54868-1388

Mailing address

1632 61St St
Brooklyn, NY 11204-2109
Phone (608) 448-6200

Other names 1

  • Dove Healthcare - Rice Lake Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240215000067 WI Part A Provider - Skilled Nursing Facility 0143664482 Practice locations: Rice Lake, WI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1205600897. Details of each certification follow.

Skilled nursing facility certification: CCN 525715

Legal name
RICE LAKE REHABILITATION AND NURSING CENTER LLC
Doing business as
DOVE HEALTHCARE - RICE LAKE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 1, 2014
Last certification
Jun 13, 2024
Beds
50
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Enrollment address
910 Bear Paw Ave
Rice Lake, WI 54868-1388
Nursing home name
DOVE HEALTHCARE - RICE LAKE
Affiliated entity
DOVE HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Dove Healthcare - Rice LakeCCN 525715 · All quality measures
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
3 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Oct 1, 2014
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
5044.3 residents per day on average
Chain
Dove Healthcare11 facilities in the chain

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
52D2103194Rice Lake Rehabilitation and Nursing Center LLC910 Bear Paw Ave, Rice Lake, WI 54868Certificate of waiverSep 30, 2027

National Provider Directory

National Provider Directory

Locations

1405 Truax Blvd
Eau Claire, WI 54703
Phone (715) 552-1030

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Divine HC Holdco LLC Organization, Brooklyn, NY Created for acquisition, LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jan 1, 2024 50%
Eli Scharf Individual OtherTrustee of Scharf Living Trust D Jan 1, 2024 16.66%
Jeremy J Kiley Individual Corporate OfficerCeo Jan 1, 2024
Goldstar Wisconsin Associates, LLC Organization, Los Angeles, CA LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jan 1, 2024 80%
Isaak Markovits Individual 5% Or Greater Indirect Ownership Interest Jan 1, 2024 25%
Corporate OfficerManager Jan 1, 2024
David Goldner Individual Corporate OfficerManager Jan 1, 2024
OtherTrustee of Dgyg Family Trust Dat Jan 1, 2024 16.66%
Ilan Richland Individual 5% Or Greater Indirect Ownership Interest Jan 1, 2024 25%
Hannah K Overlien Individual W-2 Managing EmployeeAdministrator Jan 1, 2024
Dove 8 Opco Holdco LLC Organization, Los Angeles, CA Created for acquisition, LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jan 1, 2024 100%
Richard Sampson Individual Contracted Managing EmployeeMedical Director Jan 1, 2024
Goldstar Capital Partners LLC Organization, Los Angeles, CA LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jan 1, 2024 50%
Goldstar-Divine Holdings Dove 8 LLC Organization, Los Angeles, CA Created for acquisition, LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jan 1, 2024 100%
Dov Goldner Individual OtherTrustee of Goldner Living Trust Jan 1, 2024 16.66%

Owners & managing parties with NPI records 1

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

Facilities with the same owner 10

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

Practitioners & affiliated clinicians

Affiliated clinicians 1

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

NPI Registry JSON

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

{
    "created_epoch": "1699920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699920000000",
    "number": "1205600897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1632 61ST ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112042109",
            "telephone_number": "608-448-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 BEAR PAW AVE",
            "city": "RICE LAKE",
            "state": "WI",
            "postal_code": "548681388",
            "telephone_number": "715-234-2604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICE LAKE REHABILITATION AND NURSING CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-14",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A",
        "authorized_official_last_name": "MARKOVITS",
        "authorized_official_first_name": "ISAAK",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "608-448-6200"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dove Healthcare - Rice Lake",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rice Lake, WI

Sources for this page

Verify at the official NPI Registry.