Organization Active NPI

Van Dyke Partners LLC

  • Skilled Nursing Facility
  • Warren, MI
National Provider Identifier
1467735977
Registry record updated Apr 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
1070000483 Issued in MI
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

Updated by the provider on Apr 9, 2026

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)CodeLicenseStatePrimary
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 Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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
LLCProprietary
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 CenterCCN 235714
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
3 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Individual
Certified
Dec 15, 2015
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9257.1 residents per day on average

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
23D2098909Windemere Park Health & Rehab Center31800 Van Dyke Avenue, Warren, MI 48093Certificate of waiverJul 15, 2027

National Provider Directory

National Provider Directory

Locations

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.

NameRoleSinceShare
David Hautamaki Individual W-2 Managing EmployeeAdministrator Jan 12, 2015 100%
Lisa Mancini Living Trust Organization, Clinton Township, MI 5% Or Greater Indirect Ownership Interest Oct 28, 2011 75%
Vijay Shenoy Individual Corporate DirectorDirector of Operations Oct 28, 2011 100%
W-2 Managing EmployeeDirector of Operations Oct 28, 2011 100%
Lisa Mancini Individual 5% Or Greater Indirect Ownership InterestTrustee, Manager Oct 28, 2011 100%
Domenica Ventimiglia Individual 5% Or Greater Indirect Ownership Interest Oct 28, 2011 25%
Barbara H. Johnson Individual W-2 Managing EmployeeDirector of Nursing Mar 16, 2015 100%
Windemere Group LLC Organization, Warren, MI 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.

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

Verify at the official NPI Registry.