Pine Haven Christian Home Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

356 Issued in WI

Legal business name

PINE HAVEN CHRISTIAN HOME INC

Practice address

220 Haven Drive
Sheboygan Falls, WI 53085

Phone

(920) 467-2401

Fax

(920) 467-7273

NPI assigned

Sep 2, 2005

Last updated

Jun 22, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Martin Halverson

Title

Cfo

Phone

(920) 550-5257

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Emily Murphy, OTR

  • Occupational Therapist
  • Sheboygan Falls, WI
  • NPI 1265199285
  NPD (past)

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

{
    "created_epoch": "1125619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434931200000",
    "number": "1881688059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 GIDDINGS AVE",
            "address_2": "PINE HAVEN CHRISTIAN HOME INC",
            "city": "SHEBOYGAN FALLS",
            "state": "WI",
            "postal_code": "530851707",
            "telephone_number": "920-467-2401",
            "fax_number": "920-467-7273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 HAVEN DRIVE",
            "city": "SHEBOYGAN FALLS",
            "state": "WI",
            "postal_code": "53085",
            "telephone_number": "920-467-2401",
            "fax_number": "920-467-7273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE HAVEN CHRISTIAN HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-02",
        "last_updated": "2015-06-22",
        "status": "A",
        "authorized_official_last_name": "HALVERSON",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "920-550-5257"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "356",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20012000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Michael Nauschultz, L.M.T.
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• Revee Marie Olson, MSOTR/L
• Scott A Paxton, D.O.
• Production Farm, Inc.
• Joan Marie Quinn, OTR
• Rachel Rautmann, APNP
• Michelle L Rejman, MD
• Samantha Lou Richardson

• Skilled Nursing Facility in Sheboygan Falls, WI
• Providers in Sheboygan Falls, 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 Jun 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.