Extendicare Homes, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

EXTENDICARE HOMES, INC.

Doing business as

Rose of Sharon Manor

Practice address

1000 Lovell Ave W
Roseville, MN 55113-4419

Phone

(651) 484-3378

Fax

(651) 484-8982

NPI assigned

Nov 17, 2006

Last updated

Mar 30, 2008By 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

Donna Jo Maassen

Title

Director of Compliance

Phone

(414) 908-8119

Specialties & licenses 1

Addresses

Other names 1

• Rose of Sharon Manor Doing business as

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206835200000",
    "number": "1881768323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W MICHIGAN ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532032903",
            "telephone_number": "414-908-8119",
            "fax_number": "414-908-7105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 LOVELL AVE W",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551134419",
            "telephone_number": "651-484-3378",
            "fax_number": "651-484-8982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXTENDICARE HOMES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2008-03-30",
        "status": "A",
        "authorized_official_last_name": "MAASSEN",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "DIRECTOR OF COMPLIANCE",
        "authorized_official_telephone_number": "414-908-8119"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rose of Sharon Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bruce Estrem
• Christine Jill Etter, RPH
• Anton Dante Evans, LMFT
• Trevor Lee Everett, M.D.
• Expressive Minds, LLC
• Facial Pain Center PLLC
• Jean Louise Fagerstrom, MSW, LICSW
• Faithfully Massage & Bodywork, LLC
• Lauren Falk, PT, DPT, ATC, CSCS
• Kecia K Farley, FNP-C

• Skilled Nursing Facility in Roseville, MN
• Providers in Roseville, MN by specialty
• Skilled Nursing Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2008; 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.