Provider Demographics
NPI:1689978215
Name:SHARPE CARE NURSING & REHABILITATION CENTER LLC
Entity Type:Organization
Organization Name:SHARPE CARE NURSING & REHABILITATION CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MOSHE
Authorized Official - Middle Name:
Authorized Official - Last Name:ORLINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-588-7518
Mailing Address - Street 1:1 METROPOLITAN SQ STE 2035
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63102-2729
Mailing Address - Country:US
Mailing Address - Phone:314-588-7518
Mailing Address - Fax:
Practice Address - Street 1:100 E HIGHLAND DR
Practice Address - Street 2:
Practice Address - City:OCONTO FALLS
Practice Address - State:WI
Practice Address - Zip Code:54154-1001
Practice Address - Country:US
Practice Address - Phone:920-848-3272
Practice Address - Fax:920-848-2516
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-22
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2727314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI20188600Medicaid
WI100012951Medicaid
WI525449Medicare Oscar/Certification