WISTERIA HAUS
NPI 1417466152
Nursing Facility/Intermediate Care Facility in Two Rivers, WI

Q: What is North Oak Health Care Wisteria Haus LLC's specialty?

The primary specialty registered for this NPI is Nursing Facility/Intermediate Care Facility with taxonomy code 313M00000X.

Active since September 26, 2017CLIA 52D0964184 · Waiver

2741 45TH ST, TWO RIVERS, WI 54241(847) 612-0750(920) 794-4057 Get Directions Write a Review

NPPES record last updated: August 14, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Wisteria Haus NPPES

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

WISTERIA HAUS (NPI 1417466152) is a healthcare organization registered as a nursing facility/intermediate care facility in Two Rivers, Wisconsin and active in the NPI registry since September 2017. The organization holds a CLIA Waiver certificate valid through August 18, 2027 and lists Dean Carl Maschoff, Member, as its authorized official.

NPPES Registry Identity

NPI1417466152

Entity TypeOrganization

Primary Taxonomy313M00000X

Legal Business NameNORTH OAK HEALTH CARE WISTERIA HAUS LLC

Location Address2741 45TH STTwo Rivers, WI 54241-1002

Mailing Address1025 Shermer RdNorthbrook, IL 60062-3730

Phone(847) 612-0750

Fax(920) 794-4057

Organization SubpartNo

Authorized OfficialDean Carl MaschoffMember · (847) 612-0750

Enumeration DateSeptember 26, 2017

Last NPPES UpdateAugust 14, 2020

NPPES CertifiedAugust 14, 2020

✔ NPI 1417466152 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNursing Facility/Intermediate Care FacilityNursing & Custodial Care Facilities

Taxonomy Code313M00000X

License✔ Licensed in WI · 0016823

Definition

An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.

Also ListedAssisted Living FacilityTaxonomy 310400000X

2741 45TH ST, Two Rivers, WI 54241

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Other Names 1

Doing Business AsWisteria Haus

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 52D0964184

Wisteria Haus · Two Rivers, WI

Active · expires Aug 18, 2027

CLIA Number52D0964184

Laboratory TypeAssisted Living Facility

Certificate Effective DateAugust 19, 2025

Certificate Expiration DateAugust 18, 2027

Laboratory DirectorDolores Mantik

Laboratory Phone(920) 793-1520

Laboratory LocationWisteria Haus2741 45th St, Two Rivers, WI 54241

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory to perform only waived tests.

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 North Oak Health Care Wisteria Haus LLC's NPI number?

The NPI number for North Oak Health Care Wisteria Haus LLC is 1417466152. It was assigned to this organization in the NPPES registry on September 26, 2017. The provider is doing business as Wisteria Haus.

Where is North Oak Health Care Wisteria Haus LLC located?

North Oak Health Care Wisteria Haus LLC is located at 2741 45th St, Two Rivers, WI 54241. The listed phone number is (847) 612-0750.

What is North Oak Health Care Wisteria Haus LLC's specialty?

The primary specialty registered for this NPI is Nursing Facility/Intermediate Care Facility with taxonomy code 313M00000X.

Does North Oak Health Care Wisteria Haus LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 52D0964184) is associated with this NPI, valid through August 18, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for North Oak Health Care Wisteria Haus LLC was last updated on August 14, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.