Wolf River Healthcare LLC
Organization Active NPI Skilled Nursing Facility · Clintonville, WI
NPI 1811313604 · NPPES record last updated Sep 25, 2025
Key facts
- NPI
- 1811313604
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- WOLF RIVER HEALTHCARE LLC
- Practice address
- 70 W Green Tree Rd
Clintonville, WI 54929-1009 - Phone
- (715) 823-2194
- Fax
- (715) 823-1306
- NPI assigned
- Mar 17, 2014
- Organization subpart
- No
Authorized official
- Name
- Soon Burnam
- Title
- Secretary
- Phone
- (949) 540-1249
Owners & managing parties with NPI records 1
-
Shayna Kamin, DO
Facilities with the same owner 20
Affiliated clinicians 1
-
Shayna Kamin, DO
Medicare Care Compare: Nursing home
- Listed as
- Greentree Health and Rehabilitation Center
- Overall star rating
- ★★★☆☆ 3 of 5
- Health inspections
- ★★★☆☆ 3 of 5
- Staffing
- ★★★☆☆ 3 of 5
- Quality measures
- ★★★☆☆ 3 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Feb 1, 1984
- Medicare certification status
- Active
- Certified beds
- 50 · 37.0 residents per day on average
- Chain
- The Ensign Group
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Skilled nursing facility certification: CCN 525348
- Legal name
- WOLF RIVER HEALTHCARE INC
- Doing business as
- GREENTREE HEALTH AND REHABILITATION CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Feb 1, 1984
- Last certification
- Apr 23, 2025
- Beds
- 50
- Ownership / control type
- Corporation
- Multi-facility organization
- ensign group
- Most recent change of ownership
- Jun 1, 2014
- Organization structure
- Corporation · Proprietary
- Incorporated
- Dec 19, 2013 in NV
- Enrollment address
- 70 W Green Tree Rd
Clintonville, WI 54929-1009 - Nursing home name
- GREENTREE HEALTH AND REHABILITATION CENTER
- Affiliated entity
- THE ENSIGN GROUP
All disclosed owners & managing parties 12
| Name | Role | Since | Share |
|---|---|---|---|
| Shayna K Kamin |
Operational/Managerial Control | Nov 1, 2024 | |
| Managing Control - Governing Body |
Nov 1, 2024 | ||
| Adp of the SNF | Jun 27, 2025 | ||
| PRN Health Services, Inc. |
Operational/Managerial Control | Jun 1, 2014 | |
| Barry Port |
Corporate Director |
Jan 1, 2022 | |
| The Ensign Group Inc |
5% Or Greater Indirect Ownership Interest | May 23, 2011 | 100% |
| Adp of the SNF | Jan 1, 2022 | ||
| Ensign Services Inc |
Adp of the SNF | Jan 1, 2022 | |
| Gateway Healthcare LLC |
5% Or Greater Direct Ownership Interest | Jan 1, 2024 | 100% |
| Chad Keetch |
Corporate Officer |
Mar 1, 2011 | |
| Standard Bearer Healthcare Op, LP |
Adp of the SNF | Jan 1, 2022 | |
| Deer Creek Health Holdings LLC |
Adp of the SNF | Jan 1, 2022 | |
| J Thompson Staffing Inc |
Operational/Managerial Control | Jun 1, 2014 | |
| Marissa E. Neas |
Operational/Managerial Control |
Jun 1, 2014 | |
| Managing Control - Governing Body |
Jun 1, 2014 | ||
| Adp of the SNF | Jun 27, 2025 | ||
| Soon Burnam |
Corporate Officer |
Dec 20, 2013 | |
| Managing Control - Governing Body |
Jan 1, 2022 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140610000483 | WI | Part a Provider - Skilled Nursing Facility | 3779707997 | Practice locations: Clintonville, WI |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | WI | Yes |
Addresses
Primary practice location
70 W Green Tree Rd
Clintonville, WI 54929-1009
Mailing address
70 W Green Tree Rd
Clintonville, WI 54929-1009
Phone (715) 823-2194
Other names
- Greentree Health and Rehabilitation Center
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service | Other | eSolutions Inc. |
Other providers in Clintonville, WI
- Thedacare Medical Center - Shawano, Inc.
- Jill I. Timm
- Walgreen Co
- Melanie Lynne Wilke
- Jennifer Ann Winkler
All providers in Clintonville, 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 Sep 25, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- 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.