NPIMap

Organization Active NPI

Calumet Homestead Rehabilitation Center

  • Skilled Nursing Facility
  • New Holstein, WI
National Provider Identifier
1629106570
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
2366 Issued in WI
Legal business name
CALUMET HOMESTEAD REHABILITATION CENTER
Practice address
1712 Monroe St
New Holstein, WI 53061-1307
Phone
(920) 898-4296
Fax
(920) 898-4931
NPI assigned
Mar 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Debra J Anhalt
Title
Office Manager
Phone
(920) 898-4296

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 2366 WI Primary

Addresses

Primary practice location

1712 Monroe St
New Holstein, WI 53061-1307

Mailing address

1712 Monroe St
New Holstein, WI 53061-1307
Phone (920) 898-4296

Other identifiers 1

IdentifierTypeStateIssuer
20133400MedicaidWI

National Provider Directory

National Provider Directory
Tax ID family
Calumet County Department of Human Services11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629106570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "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"
        },
        {
            "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": "CALUMET HOMESTEAD REHABILITATION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ANHALT",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "920-898-4296",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "2366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20133400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Holstein, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.