Extendicare Homes, Inc.
Organization Active NPI Skilled Nursing Facility · Weyauwega, WI
NPI 1760554281 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1760554281
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- EXTENDICARE HOMES, INC.
- Practice address
- 717 E Alfred St
Weyauwega, WI 54983-9024 - Phone
- (920) 867-3121
- Fax
- (920) 867-3997
- NPI assigned
- Nov 14, 2006
- Organization subpart
- No
Authorized official
- Name
- Donna Jo Maassen
- Title
- Director of Compliance
- Phone
- (414) 908-8119
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Yes |
Addresses
Primary practice location
717 E Alfred St
Weyauwega, WI 54983-9024
Mailing address
111 W Michigan St
Milwaukee, WI 53203-2903
Phone (414) 908-8119
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20116000 | Medicaid | WI |
Other names
- Weyauwega Health Care Center
Other providers in Weyauwega, WI
- Theresa Ellen Cane-Petersen
- County of Waupaca
- Crossroads Care Center of Weyauwega, LLC
- Michelle Ann Dean
- Brian Domrzalski
- Craig M Gorst
- Victoria Hillskotter
- Iris Health Clinic LLC
- Tatiana Jansen
- Kevin Richard Johnson
All providers in Weyauwega, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.