Homme Home for the Aging Inc.
Organization Active NPI Skilled Nursing Facility · Wittenberg, WI
NPI 1508901158 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1508901158
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 306 (WI)
- Legal business name
- HOMME HOME FOR THE AGING INC.
- Practice address
- 604 S Webb St
Wittenberg, WI 54499-9040 - Phone
- (715) 253-2125
- Fax
- (715) 253-3538
- NPI assigned
- Feb 21, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. Rodney Wendorf
- Title
- Cfo
- Phone
- (715) 253-2125
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 52D0395761 | Homme Home for the Aging Inc | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 306 | WI | Yes |
Addresses
Primary practice location
604 S Webb St
Wittenberg, WI 54499-9040
Mailing address
604 S Webb St
Wittenberg, WI 54499-9040
Phone (715) 253-2125
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20-153700 | Medicaid | WI |
Other names
- Homme Home of Wittenberg
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All providers in Wittenberg, 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 Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- 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.