Benevolent Corporation Cedar Community

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

CERTIFICATION# 022 Issued in WI

Legal business name

BENEVOLENT CORPORATION CEDAR COMMUNITY

Practice address

5555 Cedar Bay
West Bend, WI 53095-7602

Phone

(262) 306-2130

Fax

(262) 306-2131

NPI assigned

Jul 27, 2005

Last updated

May 9, 2019By the provider in NPPES

Organization subpart

Yes

Parent organization

BENEVOLENT CORPORATION CEDAR COMMUNITYAs reported in NPPES

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

Authorized official

Name

Mr. Joseph T Pichler

Title

Vice President of Finance

Phone

(262) 306-4212

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Benevolent Corporation Cedar Community

  • Custodial Care Facility
  • West Bend, WI
  • NPI 1194909341

  O20080204000012

  Same enrollment
• Benevolent Corporation Cedar Community

  dba Cedar Lake Health and Rehabilitation Center

  • Skilled Nursing Facility
  • West Bend, WI
  • NPI 1811997695

  O20080204000012

  Same enrollment
• Benevolent Corporation Cedar Community

  dba Cedar Bay East

  • Assisted Living Facility
  • West Bend, WI
  • NPI 1851391304

  O20080204000012

  Same enrollment

Part of

Cedar Haven Rehab Agenc

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Benevolent Corporation Cedar Community

  dba Cottages at Cedar Run

  • Assisted Living Facility
  • West Bend, WI
  • NPI 1972054138
  NPPES parent name

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

{
    "created_epoch": "1122422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557360000000",
    "number": "1487654935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 CEDAR BAY",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530957602",
            "telephone_number": "262-306-2130",
            "fax_number": "262-306-2131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 CEDAR BAY",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530957602",
            "telephone_number": "262-306-2130",
            "fax_number": "262-306-2131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENEVOLENT CORPORATION CEDAR COMMUNITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BENEVOLENT CORPORATION CEDAR COMMUNITY",
        "enumeration_date": "2005-07-27",
        "last_updated": "2019-05-09",
        "status": "A",
        "authorized_official_last_name": "PICHLER",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "VICE PRESIDENT OF FINANCE",
        "authorized_official_telephone_number": "262-306-4212",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "WI",
            "license": "CERTIFICATION# 022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terrance J Benda, DPM
• Janel Benedum, APSW
• Benevolent Corporation Cedar Community (Cedar Lake Campus Pharmacy)
• Benevolent Corporation Cedar Community (Cedar Community Hospice)
• Benevolent Corporation Cedar Community
• Benevolent Corporation Cedar Community (Cedar Haven Rehabilitation Services)
• Benevolent Corporation Cedar Community (Cedar Community Home Health Agency)
• Benevolent Corporation Cedar Community (Cedar Lake Health and Rehabilitation Center)
• Benevolent Corporation Cedar Community (Cedar Bay East)
• Benevolent Corporation Cedar Community (Cottages at Cedar Run)

• Assisted Living Facility in West Bend, WI
• Providers in West Bend, WI by specialty
• Assisted Living Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.