NPIMap

Organization Active NPI

Homecare Health Services Inc

  • Community Based Hospice Care Agency
  • Manitowoc, WI
National Provider Identifier
1992891758
Registry record updated Mar 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
1508 Issued in WI
Legal business name
HOMECARE HEALTH SERVICES INC
Practice address
1004 Washington St
Manitowoc, WI 54220-5207
Phone
(920) 684-7155
NPI assigned
Oct 5, 2006
Organization subpart
Yes
Parent organization
HOMECARE HEALTH SERVICES INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 24, 2010

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

Authorized official

Name
Jeremy Seidl
Title
Operations Manager
Phone
(920) 684-7155

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 1508 WI Primary

Addresses

Primary practice location

1004 Washington St
Manitowoc, WI 54220-5207

Mailing address

1004 Washington St
Manitowoc, WI 54220-5207
Phone (920) 684-7155

Other names 1

  • MANITOWOC COUNTY COMMUNITY HOSPICE Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100125000564 WI Part A Provider - Hospice 9537201801 Practice locations: Manitowoc, WI

Hospice certification: CCN 521508

Legal name
HOMECARE HEALTH SERVICES INC
Doing business as
MANITOWOC COUNTY COMMUNITY HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Apr 28, 1986
Last certification
Jan 26, 2021
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
May 27, 1975 in WI
Enrollment address
1004 Washington Street
Manitowoc, WI 54220-5207

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospice

Medicare Care Compare
Listed as
Homecare Health Services HospiceCCN 521508
Ownership
For-Profit
Certified
Apr 28, 1986
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Homecare Health Services Inc2 organizations share this tax ID, including this one
Part of
Homecare Health Services Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1004 Washington St
Manitowoc, WI 54220
Phone (920) 684-7155

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Jeremy Seidl Individual W-2 Managing Employee Mar 6, 1995
Lynn Seidl Babcock Individual 5% Or Greater Direct Ownership Interest Apr 13, 2020 100%
Corporate Director Jul 15, 1987
W-2 Managing EmployeeAd; Jul 15, 1987
Matthew Campbell Individual W-2 Managing EmployeeMD; Apr 30, 2018 25%

Owners & managing parties with NPI records 1

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

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Affiliated clinicians 3

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": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269388800000",
    "number": "1992891758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 WASHINGTON ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542205207",
            "telephone_number": "920-684-7155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 WASHINGTON ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542205207",
            "telephone_number": "920-684-7155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMECARE HEALTH SERVICES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HOMECARE HEALTH SERVICES INC",
        "enumeration_date": "2006-10-05",
        "last_updated": "2010-03-24",
        "status": "A",
        "authorized_official_last_name": "SEIDL",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "920-684-7155"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "WI",
            "license": "1508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MANITOWOC COUNTY COMMUNITY HOSPICE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Manitowoc, WI

Sources for this page

Verify at the official NPI Registry.