LSS of Sheboygan, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

2363 Issued in WI

Legal business name

LSS OF SHEBOYGAN, LLC

Practice address

3014 Erie Ave
Sheboygan, WI 53081-3658

Phone

(920) 459-3028

Fax

(920) 459-4341

NPI assigned

Nov 14, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Jeanne Stark

Title

Administrator

Phone

(920) 459-3028

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Sunny Ridge Health and Rehabilitation Center Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Legacy Senior Services

  • Skilled Nursing Facility
  • Frazee, MN
  • NPI 1255510889

  Member Of

  NPD member

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184630400000",
    "number": "1801968847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3014 ERIE AVENUE",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "53081",
            "telephone_number": "920-459-3028",
            "fax_number": "920-459-4341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3014 ERIE AVE",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530813658",
            "telephone_number": "920-459-3028",
            "fax_number": "920-459-4341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LSS OF SHEBOYGAN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2007-07-17",
        "status": "A",
        "authorized_official_last_name": "STARK",
        "authorized_official_first_name": "JEANNE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "920-459-3028",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "2363",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20198500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sunny Ridge Health and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Erica R. Loppnow, APNP
• Mandy Marie Lorenz, RN
• Katherine A Loveless, ACNP
• Mary Fitzgerald Lovelien, PA-C
• Rizwan Loya, MD
• Emily Joann Lucht, M.S. OTR/L
• Sarah Luethy
• Judith L Lukach, RPH
• Joshua R Luna, OTR
• Trisha Renee Lund, LCSW

• Skilled Nursing Facility in Sheboygan, WI
• Providers in Sheboygan, 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 Jul 17, 2007; 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.