Samaritan Fields CBRF LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SAMARITAN FIELDS CBRF LLC

Practice address

531 E Washington St
West Bend, WI 53095-2531

Phone

(262) 335-4502

NPI assigned

Jun 3, 2024

Organization subpart

No

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

Authorized official

Name

Mr. Jacob Jeidel

Title

Sole Member

Phone

(917) 750-5089

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1717372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717372800000",
    "number": "1841031135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 E WASHINGTON ST",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530952531",
            "telephone_number": "262-335-4502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 E WASHINGTON ST",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530952531",
            "telephone_number": "262-335-4502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMARITAN FIELDS CBRF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-03",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A",
        "authorized_official_last_name": "JEIDEL",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "917-750-5089",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin Sabel, RN
• Jackson Leo Sadler
• Allison R Sajdak Hetzel, APNP
• Daniel E Sajdak, DO
• Tammy Nicole Salas, M.S. CCC-SLP
• Samaritan Fields Rcac LLC
• Samaritan Health Center Subacute Unit
• Samaritan Nursing and Rehab LLC
• Charles E Sammis, DO
• Warren W Samplaski, RPH

• Assisted Living Facility in West Bend, WI
• Providers in West Bend, WI by specialty
• Assisted Living Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; 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.