WATERS EDGE REHABILITATION AND CARE CENTER
NPI 1174949663
Skilled Nursing Facility in Kenosha, WI

Active since March 09, 2014CLIA 52D0389427 · Waiver
3415 SHERIDAN RD, KENOSHA, WI 53140(262) 657-6175(262) 653-8441 Get Directions Write a Review

NPPES record last updated: December 2, 2015. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Waters Edge Rehabilitation And Care Center NPPES

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

WATERS EDGE REHABILITATION AND CARE CENTER (NPI 1174949663) is a healthcare organization registered as a skilled nursing facility in Kenosha, Wisconsin and active in the NPI registry since March 2014. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Judah Bienstock, Consultant, as its authorized official.

NPPES Registry Identity

NPI1174949663
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameWOODSTOCK HEALTH CARE LLC
Location Address3415 SHERIDAN RDKenosha, WI 53140-1924
Mailing Address3415 Sheridan RdKenosha, WI 53140-1924 · (262) 657-6175 · Fax (262) 653-8441
Fax(262) 653-8441
Organization SubpartNo
Authorized OfficialJudah BienstockConsultant · (314) 631-3000
Enumeration DateMarch 9, 2014
Last NPPES UpdateDecember 2, 2015
NPI 1174949663 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
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.

3415 SHERIDAN RD, Kenosha, WI 53140

Other Names 1

Doing Business AsWaters Edge Rehabilitation And Care Center

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 52D0389427

Waters Edge Rehabilitation And Care Center · Kenosha, WI
Active · expires Aug 31, 2026
CLIA Number52D0389427
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorElizabeth Haswah
Laboratory Phone(262) 657-6175
Laboratory LocationWaters Edge Rehabilitation And Care Center3415 Sheridan Rd, Kenosha, WI 53140
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

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

Occupational Therapy Assistant
3415 SHERIDAN RD
KENOSHA, WI 53140
Specialist
3415 SHERIDAN RD
KENOSHA, WI 53140
Speech-Language Pathologist
3415 SHERIDAN RD
KENOSHA, WI 53140
Occupational Therapist
3415 SHERIDAN RD
KENOSHA, WI 53140
Speech-Language Pathologist
3415 SHERIDAN RD
KENOSHA, WI 53140
Skilled Nursing Facility
3415 SHERIDAN RD
KENOSHA, WI 53140
Occupational Therapy Assistant
3415 SHERIDAN RD
KENOSHA, WI 53140
Physical Therapy Assistant
3415 SHERIDAN RD
KENOSHA, WI 53140

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 Woodstock Health Care LLC's NPI number?

The NPI number for Woodstock Health Care LLC is 1174949663. It was assigned to this organization in the NPPES registry on March 9, 2014. The provider is doing business as Waters Edge Rehabilitation And Care Center.

Where is Woodstock Health Care LLC located?

Woodstock Health Care LLC is located at 3415 Sheridan Rd, Kenosha, WI 53140. The listed phone number is (262) 657-6175.

What is Woodstock Health Care LLC's specialty?

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

Does Woodstock Health Care LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 52D0389427) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Woodstock Health Care LLC was last updated on December 2, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.