EDENBROOK LAKESIDE
NPI 1053803031
Skilled Nursing Facility in Milwaukee, WI

Active since June 05, 2018CLIA 52D0687199 · Waiver
1/5
Overall Rating
2115 E WOODSTOCK PL, MILWAUKEE, WI 53202(414) 271-1020 Get Directions Write a Review

NPPES record last updated: September 16, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Sep 16, 2020, Oct 3, 2018 (2 updates tracked since 2018).

About Edenbrook Lakeside NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EDENBROOK LAKESIDE (NPI 1053803031) is a healthcare organization registered as a skilled nursing facility in Milwaukee, Wisconsin and active in the NPI registry since June 2018. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Max Stesel, Owner, as its authorized official.

NPPES Registry Identity

NPI1053803031
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameLAKE TERRACE NURSING AND REHAB LLC
Location Address2115 E WOODSTOCK PLMilwaukee, WI 53202-1342
Mailing Address8170 Mccormick Blvd Ste 112Skokie, IL 60076-2914 · (773) 825-3336 · Fax (847) 423-6991
Organization SubpartNo
Authorized OfficialMax SteselOwner · (773) 825-3336
Enumeration DateJune 5, 2018
Last NPPES UpdateSeptember 16, 20202 updates tracked since enumeration
NPPES CertifiedSeptember 16, 2020
NPI 1053803031 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in WI · 3150
Definition

(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

2115 E WOODSTOCK PL, Milwaukee, WI 53202

Other Names 1

Doing Business AsEdenbrook Lakeside

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 52D0687199

Edenbrook Lakeside · Milwaukee, WI
Active · expires Aug 31, 2026
CLIA Number52D0687199
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorSam Antoniewicz
Laboratory Phone(414) 758-2044
Laboratory LocationEdenbrook Lakeside2115 East Woodstock Place, Milwaukee, WI 53202
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Nursing Home Quality Ratings CMS Care Compare

Quality ratings, staffing and inspection history for Edenbrook Lakeside (CMS certification number 525319), from CMS Care Compare.

Edenbrook Lakeside

Nursing home · Milwaukee, WI
1/5 CMS Overall Rating
OwnershipFor profit - Corporation
CMS Certification Number525319
Certified Beds130 beds93 residents per day on average
Medicare & Medicaid Participant SinceJanuary 1, 1982
Resident & Family CouncilResident council
Automatic sprinkler system

CMS Star Ratings

Quality Measures
Based on a select set of clinical quality measures.
3/5
Long-Stay Quality
Quality of care delivered to long-term residents.
4/5
Short-Stay Quality
Quality of care delivered to short-term and rehabilitation residents.
3/5
Staffing
Based on nursing staff hours relative to resident needs.
2/5
Weighted Health Inspection Score
Lower scores are better; the score summarizes deficiencies found on recent inspections.
153.67
Ratings are assigned by CMS on a one-to-five star scale; five is the highest. Categories without a current CMS rating are not shown.

Staffing & Turnover

Total Nurse Staffing
nurse aide 2.27 · LPN 0.57 · RN 0.8
3.64 hrs per resident per day
Weekend Nurse Staffing
3.11 hrs per resident per day
Physical Therapist Staffing
0.12 hrs per resident per day
Nursing Staff Turnover
Share of nursing staff who left the facility within the past year.
56.4%
Registered Nurse Turnover
31.6%
Administrators Who Have Left
In the past year.
0
Higher staffing hours generally allow more direct care time per resident.

Inspections & Enforcement

CMS has flagged this facility with its abuse flag, indicating a citation for abuse or neglect on a recent inspection report.
Facility-Reported Incidents
4
Substantiated Complaints
10
Fines
4 totaling $180,875.45
Medicare Payment Denials
1
Total Penalties
5
Counts come from CMS inspections and complaint investigations over approximately the past three years. CMS Care Compare data as of October 1, 2024.

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Occupational Therapist
2115 E WOODSTOCK PL
MILWAUKEE, WI 53202
Speech-Language Pathologist
2115 E WOODSTOCK PL
MILWAUKEE, WI 53202
Physical Therapy Assistant
2115 E WOODSTOCK PL
MILWAUKEE, WI 53202
Skilled Nursing Facility
2115 E WOODSTOCK PL
MILWAUKEE, WI 53202
Home Health
2115 E WOODSTOCK PL
MILWAUKEE, WI 53202
Speech-Language Pathologist
2115 E WOODSTOCK PL
MILWAUKEE, WI 53202
Occupational Therapist
2115 E WOODSTOCK PL
MILWAUKEE, WI 53202
Skilled Nursing Facility
2115 E WOODSTOCK PL
MILWAUKEE, WI 53202

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lake Terrace Nursing And Rehab LLC's NPI number?

The NPI number for Lake Terrace Nursing And Rehab LLC is 1053803031. It was assigned to this organization in the NPPES registry on June 5, 2018. The provider is doing business as Edenbrook Lakeside.

Where is Lake Terrace Nursing And Rehab LLC located?

Lake Terrace Nursing And Rehab LLC is located at 2115 E Woodstock Pl, Milwaukee, WI 53202. The listed phone number is (414) 271-1020.

What is Lake Terrace Nursing And Rehab LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Lake Terrace Nursing And Rehab LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 52D0687199) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is Lake Terrace Nursing And Rehab LLC a Medicare-certified nursing home?

Yes. Edenbrook Lakeside is a Medicare-certified nursing home with 130 certified beds.

What quality rating does Lake Terrace Nursing And Rehab LLC have?

CMS rates Edenbrook Lakeside 1 out of 5 stars overall on Care Compare. The full measure detail is in the Nursing Home Quality Ratings section above.

What insurance does Lake Terrace Nursing And Rehab LLC accept?

Health plans from Network Health, Security Health Plan and UnitedHealthcare list Lake Terrace Nursing And Rehab LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lake Terrace Nursing And Rehab LLC was last updated on September 16, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.