GRANCARE NURSING AND REHABILITATION CENTER
NPI 1295721991
Skilled Nursing Facility in Fond Du Lac, WI

Active since September 27, 2005CLIA 52D0675851 · Waiver
517 E DIVISION ST, FOND DU LAC, WI 54935(920) 921-6800(920) 921-6875 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Grancare Nursing And Rehabilitation Center NPPES

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

GRANCARE NURSING AND REHABILITATION CENTER (NPI 1295721991) is a healthcare organization registered as a skilled nursing facility in Fond Du Lac, Wisconsin and active in the NPI registry since September 2005. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists William L Mackenzie, Administrator, as its authorized official.

NPPES Registry Identity

NPI1295721991
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameGRANCARE INC
Location Address517 E DIVISION STFond Du Lac, WI 54935-3735
Mailing Address517 E Division StFond Du Lac, WI 54935-3735 · (920) 921-6800 · Fax (920) 921-6875
Fax(920) 921-6875
Organization SubpartNo
Authorized OfficialWilliam L MackenzieAdministrator · (920) 921-6800
Enumeration DateSeptember 27, 2005
Last NPPES UpdateAugust 22, 2020
NPI 1295721991 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 · 1044
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.

517 E DIVISION ST, Fond Du Lac, WI 54935

Other Names 1

Doing Business AsGrancare Nursing And Rehabilitation Center

Other Identifiers 1

Medicaid20193800WI

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 52D0675851

Manor Fond Du Lac, The · Fond Du Lac, WI
Active · expires Aug 31, 2026
CLIA Number52D0675851
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorRosie Rhode
Laboratory Phone(920) 921-6800
Laboratory LocationManor Fond Du Lac, The517 E Division Street, Fond Du Lac, WI 54935
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 9

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

Physical Therapist
517 E DIVISION ST
FOND DU LAC, WI 54935
Physical Therapy Assistant
517 E DIVISION ST
FOND DU LAC, WI 54935
Skilled Nursing Facility
517 E DIVISION ST
FOND DU LAC, WI 54935
Physical Therapy Assistant
517 E DIVISION ST
FOND DU LAC, WI 54935
Occupational Therapy Assistant
517 E DIVISION ST
FOND DU LAC, WI 54935
Occupational Therapist
517 E DIVISION ST
FOND DU LAC, WI 54935
Occupational Therapist
517 E DIVISION ST
FOND DU LAC, WI 54935
Skilled Nursing Facility
517 E DIVISION ST
FOND DU LAC, WI 54935

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1295721991, enumerated as an "organization" on September 27, 2005.

The provider is located at 517 E DIVISION ST FOND DU LAC, WI 54935 and the phone number is (920) 921-6800.

Skilled Nursing Facility with taxonomy code 314000000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.