Pine Manor Health Care Ctr

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

211-27 Issued in WI

Legal business name

PINE MANOR HEALTH CARE CTR

Doing business as

Greentree Health Care Ctr

Practice address

70 W Green Tree Rd
Clintonville, WI 54929-1009

Phone

(715) 823-2194

NPI assigned

Nov 30, 2011

Last updated

Nov 30, 2011By 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

Amy BrylskiNPI 1770850158

Title

Cota

Phone

(920) 475-1378

Specialties & licenses 1

Addresses

Other names 1

• Greentree Health Care Ctr Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Amy Brylski

  • Occupational Therapy Assistant
  • Appleton, WI
  • NPI 1770850158
  Authorized official Same address or phone

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

{
    "created_epoch": "1322611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322611200000",
    "number": "1285901546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 GREENTREE RD.",
            "city": "CLINTONVILLE",
            "state": "WI",
            "postal_code": "54929",
            "telephone_number": "715-823-2194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 W GREEN TREE RD",
            "city": "CLINTONVILLE",
            "state": "WI",
            "postal_code": "549291009",
            "telephone_number": "715-823-2194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE MANOR HEALTH CARE CTR",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-30",
        "last_updated": "2011-11-30",
        "status": "A",
        "authorized_official_last_name": "BRYLSKI",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "COTA",
        "authorized_official_telephone_number": "920-475-1378"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "211-27",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greentree Health Care Ctr",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joanne Rita Niemuth, COTA
• Orthopedic & Spine Therapy of Clintonville, SC
• Orthopedic & Spine Therapy of Clintonville, SC
• Pamida Stores Operating Co. LLC (Pamida Home Medical Equipment 177)
• Mark Joseph Pensis, DC
• Leonard J Purull, RPH
• Julie Kay Radtke, P.T.A.
• Mohamed Rasekh
• Jaime Rietveld, RN
• Robert R. Ritchie, PTA

• Skilled Nursing Facility in Clintonville, WI
• Providers in Clintonville, 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 Nov 30, 2011; 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.