Shady Lane Home, Inc.
NPI 1518926211ActiveOrganization· Skilled Nursing Facility· Manitowoc, WI
Skilled Nursing Facility in Manitowoc, Wisconsin, registered in NPPES in March 2006. The authorized official on file is Lisa M. Wetenkamp, Accounts Receivable. Enrolled in Medicare as part a provider - skilled nursing facility.
Overview
| NPI | 1518926211 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Mar 21, 2006 |
| Last updated in NPPES | Dec 31, 2020 |
| Certified by provider | Dec 31, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Skilled Nursing Facility Primary | 314000000X | 2250 | WI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part A Provider - Skilled Nursing Facility (WI) |
|---|
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