Homestead Care Center LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

2366 Issued in WI

Legal business name

HOMESTEAD CARE CENTER LLC

Practice address

1712 Monroe St
New Holstein, WI 53061-1307

Phone

(920) 898-4296

Fax

(920) 898-4931

NPI assigned

Nov 19, 2007

Organization subpart

No

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

Authorized official

Name

Robert M Parkins

Title

Cfo

Phone

(920) 364-9754

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• ATRIUM POST ACUTE CARE OF NEW HOLSTEIN Doing business as

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

{
    "created_epoch": "1195430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432684800000",
    "number": "1508047523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1726 N BALLARD RD",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549112444",
            "telephone_number": "920-991-9072",
            "fax_number": "920-749-4022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1712 MONROE ST",
            "city": "NEW HOLSTEIN",
            "state": "WI",
            "postal_code": "530611307",
            "telephone_number": "920-898-4296",
            "fax_number": "920-898-4931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMESTEAD CARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-19",
        "last_updated": "2015-05-27",
        "status": "A",
        "authorized_official_last_name": "PARKINS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "920-364-9754"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "2366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20199300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ATRIUM POST ACUTE CARE OF NEW HOLSTEIN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Eye Care Center of New Holstein, LLC
• FMG Hoover Street Wisconsin LLC
• Connie M Gehl
• Mary Ann Halbach, COTA
• Amber Heimermann, PTA
• Megan Joyce Koehler, RN
• Heather Kooiman
• Sarah Mary Kraus, MS/CCC/SLP
• Amanda Jo Lanham, PA-C
• Colleen Marie Mazza, PT

• Skilled Nursing Facility in New Holstein, WI
• Providers in New Holstein, 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 May 27, 2015; 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.