NSH Florence LLC
Organization Active NPI Skilled Nursing Facility · Florence, WI
NPI 1407308679 · NPPES record last updated Dec 29, 2016
Key facts
- NPI
- 1407308679
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 2909 (WI)
- Legal business name
- NSH FLORENCE LLC
- Practice address
- 5778 Chapin St
Florence, WI 54121-9443 - Phone
- (715) 528-4833
- Fax
- (715) 528-4988
- NPI assigned
- Nov 3, 2016
- Organization subpart
- Yes
- Parent organization (as reported)
- NSHC WISCONSIN LLC
Authorized official
- Name
- Jeffrey Charles Hoehn
- Title
- Managing Member
- Phone
- (414) 962-5250
Facilities with the same owner 55
Medicare Care Compare: Nursing home
- Listed as
- Florence Health Services
- Overall star rating
- ★☆☆☆☆ 1 of 5
- Health inspections
- ★☆☆☆☆ 1 of 5
- Staffing
- ★★★☆☆ 3 of 5
- Quality measures
- ★★☆☆☆ 2 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Apr 1, 1984
- Medicare certification status
- Active
- Certified beds
- 73 · 47.8 residents per day on average
- Chain
- North Shore Healthcare
- Penalties (3 years)
- 1 · fines totaling $0
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 52D0394422 | Florence Health Services | Certificate of waiver | Jun 28, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Skilled nursing facility certification: CCN 525358
- Legal name
- NSH FLORENCE LLC
- Doing business as
- FLORENCE HEALTH SERVICES
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Apr 1, 1984
- Last certification
- Nov 13, 2024
- Beds
- 73
- Ownership / control type
- Corporation
- Multi-facility organization
- North Shore Health
- Organization structure
- LLC · Proprietary
- Incorporated
- Sep 24, 2016 in WI
- Enrollment address
- 5778 Chapin St
Florence, WI 54121-9443 - Nursing home name
- FLORENCE HEALTH SERVICES
- Affiliated entity
- NORTH SHORE HEALTHCARE
All disclosed owners & managing parties 4
| Name | Role | Since | Share |
|---|---|---|---|
| Jeffrey C Hoehn |
5% Or Greater Direct Ownership Interest | Apr 4, 2017 | 50% |
| Corporate Officer |
Apr 4, 2017 | 50% | |
| Operational/Managerial Control |
Apr 4, 2017 | 50% | |
| North Shore Healthcare LLC |
5% Or Greater Indirect Ownership Interest | Apr 4, 2017 | 100% |
| Operational/Managerial Control | Apr 4, 2017 | 100% | |
| Other | Apr 4, 2017 | 100% | |
| Troy T Baumann |
5% Or Greater Direct Ownership Interest | Apr 4, 2017 | 50% |
| Corporate Officer |
Apr 4, 2017 | 50% | |
| Operational/Managerial Control |
Apr 4, 2017 | 50% | |
| NSHC Wisconsin LLC |
5% Or Greater Direct Ownership Interest | Apr 4, 2017 | 100% |
| Operational/Managerial Control | Apr 4, 2017 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170526001422 | WI | Part a Provider - Skilled Nursing Facility | 1153698949 | Practice locations: Florence, WI |
National Provider Directory
Locations
5778 Chapin St
Florence, WI 54121
Phone (715) 528-4833
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 2909 | WI | Yes |
Addresses
Primary practice location
5778 Chapin St
Florence, WI 54121-9443
Mailing address
5150 N Port Washington Rd
Suite 260
Glendale, WI 53217-5474
Phone (414) 962-5250
Other names
- Florence Health Services
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All providers in Florence, 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 Dec 29, 2016. 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.