NPIMap

Organization Active NPI

Wolf River Healthcare LLC

Doing business as Greentree Health and Rehabilitation Center

  • Skilled Nursing Facility
  • Clintonville, WI
National Provider Identifier
1811313604
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
WOLF RIVER HEALTHCARE LLC
Doing business as
Greentree Health and Rehabilitation Center
Practice address
70 W Green Tree Rd
Clintonville, WI 54929-1009
Phone
(715) 823-2194
Fax
(715) 823-1306
NPI assigned
Mar 17, 2014
Last updated
Sep 25, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2025

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

Authorized official

Name
Soon Burnam
Title
Secretary
Phone
(949) 540-1249

Specialties & licenses 1

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

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 1

  • Greentree Health and Rehabilitation Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140610000483 WI Part A Provider - Skilled Nursing Facility 3779707997 Practice locations: Clintonville, WI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1811313604. Details of each certification follow.

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
CorporationProprietary
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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Greentree Health and Rehabilitation CenterCCN 525348 · All quality measures
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
ActiveFrom the Provider of Services file
Certified beds
5037.0 residents per day on average
Chain
The Ensign Group342 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Shayna K Kamin Individual Operational/Managerial Control Nov 1, 2024
Managing Control - Governing BodyMedical Director Nov 1, 2024
Adp of the SNF Jun 27, 2025
PRN Health Services, Inc. Organization, Appleton, WI Corporation Operational/Managerial Control Jun 1, 2014
Barry Port Individual Corporate DirectorSole Manager Gateway Healthcare LLC Jan 1, 2022
The Ensign Group Inc Organization, San Juan Capistrano, CA Corporation 5% Or Greater Indirect Ownership Interest May 23, 2011 100%
Adp of the SNF Jan 1, 2022
Ensign Services Inc Organization, San Juan Capistrano, CA Corporation Adp of the SNF Jan 1, 2022
Gateway Healthcare LLC Organization, San Juan Capistrano, CA LLC 5% Or Greater Direct Ownership Interest Jan 1, 2024 100%
Chad Keetch Individual Corporate OfficerSole Manger Wolf River Healthcare L Mar 1, 2011
Standard Bearer Healthcare Op, LP Organization, San Juan Capistrano, CA Adp of the SNF Jan 1, 2022
Deer Creek Health Holdings LLC Organization, San Juan Capistrano, CA LLC Adp of the SNF Jan 1, 2022
J Thompson Staffing Inc Organization, Dallas, TX Corporation Operational/Managerial Control Jun 1, 2014
Marissa E. Neas Individual Operational/Managerial ControlAdministrator Jun 1, 2014
Managing Control - Governing BodyAdministrator Jun 1, 2014
Adp of the SNF Jun 27, 2025
Soon Burnam Individual Corporate OfficerSecretary Wolf River Healthcare LLC Dec 20, 2013
Managing Control - Governing BodyAuthorized Official Jan 1, 2022

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Shayna Kamin, DO
    • Geriatric Medicine (Family Medicine) Physician
    • Appleton, WI
    • NPI 1609281567

    Adp of the SNF, Managing Control - Governing Body, Operational/Managerial Control

    CMS ownership

Facilities with the same owner 20

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 20

Practitioners & affiliated clinicians

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1395014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758758400000",
    "number": "1811313604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 W GREEN TREE RD",
            "city": "CLINTONVILLE",
            "state": "WI",
            "postal_code": "549291009",
            "telephone_number": "715-823-2194",
            "fax_number": "715-823-1306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 W GREEN TREE RD",
            "city": "CLINTONVILLE",
            "state": "WI",
            "postal_code": "549291009",
            "telephone_number": "715-823-2194",
            "fax_number": "715-823-1306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOLF RIVER HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-17",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A",
        "authorized_official_last_name": "BURNAM",
        "authorized_official_first_name": "SOON",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "949-540-1249"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113833.3.1066.1",
            "affiliationName": "eSolutions Inc.",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CSV",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Greentree Health and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Greentree Health and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clintonville, WI

Sources for this page

Verify at the official NPI Registry.