Active NPI
Van Dyke Partners LLC
- Skilled Nursing Facility
- Warren, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 1070000483
- Legal business name
- VAN DYKE PARTNERS LLC
- Practice address
- 31800 Van Dyke Ave
Warren, MI 48093-7907 - Phone
- (586) 264-9701
- Fax
- (586) 264-9702
- NPI assigned
- Sep 21, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lisa Mancini
- Title
- Manager
- Phone
- (810) 459-0532
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 1070000483 | MI | Primary |
Addresses
Primary practice location
31800 Van Dyke Ave
Warren, MI 48093-7907
Mailing address
31800 Van Dyke Ave
Warren, MI 48093-7907
Phone (586) 722-2600
Other names 1
- Windemere Park Health & Rehab Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160106000925 | MI | Part A Provider - Skilled Nursing Facility | 1951537372 | Practice locations: Warren, MI |
Skilled nursing facility certification: CCN 235714
- Legal name
- VAN DYKE PARTNERS LLC
- Doing business as
- WINDEMERE PARK HEALTH & REHAB CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Dec 15, 2015
- Last certification
- Apr 30, 2025
- Beds
- 92
- Ownership / control type
- Corporation
- Organization structure
- LLC
- Incorporated
- Aug 20, 2003 in MI
- Enrollment address
- 31800 Van Dyke Ave
Warren, MI 48093-7907 - Nursing home name
- WINDEMERE PARK HEALTH AND REHABILITATION CENTER
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Windemere Park Health and Rehabilitation Center
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Individual
- Certified
- Dec 15, 2015
- Medicare certification status
- Active
- Certified beds
- 92
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 23D2098909 | Windemere Park Health & Rehab Center | Certificate of waiver | Jul 15, 2027 |
National Provider Directory
National Provider DirectoryLocations
30078 Schoenherr Rd
Ste 300
Warren, MI 48088
Ownership & related parties
All disclosed owners & managing parties 7
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| David Hautamaki | W-2 Managing Employee | Jan 12, 2015 | 100% |
| Lisa Mancini Living Trust | 5% Or Greater Indirect Ownership Interest | Oct 28, 2011 | 75% |
| Vijay Shenoy | Corporate Director | Oct 28, 2011 | 100% |
| W-2 Managing Employee | Oct 28, 2011 | 100% | |
| Lisa Mancini | 5% Or Greater Indirect Ownership Interest | Oct 28, 2011 | 100% |
| Domenica Ventimiglia | 5% Or Greater Indirect Ownership Interest | Oct 28, 2011 | 25% |
| Barbara H. Johnson | W-2 Managing Employee | Mar 16, 2015 | 100% |
| Windemere Group LLC | 5% Or Greater Direct Ownership Interest | May 16, 2011 | 100% |
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Troy, MI
- NPI 1457507006
-
- Internal Medicine Physician
- Detroit, MI
- NPI 1265747463
-
- Internal Medicine Physician
- Livonia, MI
- NPI 1548244304
-
- Internal Medicine Physician
- Warren, MI
- NPI 1508874504
Affiliated clinicians 2
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": "1316563200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1775692800000",
"number": "1467735977",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31800 VAN DYKE AVE",
"city": "WARREN",
"state": "MI",
"postal_code": "480937907",
"telephone_number": "586-722-2600",
"fax_number": "586-722-2613"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "31800 VAN DYKE AVE",
"city": "WARREN",
"state": "MI",
"postal_code": "480937907",
"telephone_number": "586-264-9701",
"fax_number": "586-264-9702"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VAN DYKE PARTNERS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2011-09-21",
"last_updated": "2026-04-09",
"certification_date": "2026-04-09",
"status": "A",
"authorized_official_last_name": "MANCINI",
"authorized_official_first_name": "LISA",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "810-459-0532"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "MI",
"license": "1070000483",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Windemere Park Health & Rehab Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Warren, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.