WISTERIA HAUS
NPI 1417466152
Nursing Facility/Intermediate Care Facility in Two Rivers, WI
NPI Status: Active since September 26, 2017
Contact Information
2741 45TH ST
TWO RIVERS, WI
ZIP 54241
Phone: (847) 612-0750
Fax: (920) 794-4057
- Organization
- Nursing Facility/Intermediate Care Facil...
- CLIA Number: 52D0964184
- CLIA Cert. Type: Assisted Living Facility
- CLIA Exp. Date: 08-18-2027
About WISTERIA HAUS
This page provides the complete NPI Profile along with additional information for Wisteria Haus, a provider established in Two Rivers, Wisconsin operating as a Nursing Facility/intermediate Care Facility. The healthcare provider is registered in the NPI registry with number 1417466152 assigned on September 2017. The practitioner's primary taxonomy code is 313M00000X with license number 0016823 (WI). The provider is registered as an organization and their NPI record was last updated 6 years ago. The provider's is doing business as Wisteria Haus. The authorized official of this NPI record is Mr. Dean Carl Maschoff (Member)
- NPI
- 1417466152
- Provider Legal Name
- NORTH OAK HEALTH CARE WISTERIA HAUS LLC
- Other Organization Name
- WISTERIA HAUS
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 2741 45TH ST TWO RIVERS, WI 54241
- Location Phone
- (847) 612-0750
- Location Fax
- (920) 794-4057
- Mailing Address
- 1025 SHERMER RD NORTHBROOK, IL 60062
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 09-26-2017
- Last Update Date
- 08-14-2020
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Nursing Facility/Intermediate Care Facility
- Taxonomy Code
- 313M00000X
- Type
- Nursing & Custodial Care Facilities
- License No.
- 0016823
- License State
- WI
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 310400000X | Nursing & Custodial Care Facilities | Assisted Living Facility |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 52D0964184
- Facility Type
- Assisted Living Facility
- Certificate Effective Date
- August 19, 2025
- Certificate Expiration Date
- August 18, 2027
- Laboratory Director
- DOLORES MANTIK
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Wisteria Haus to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for WISTERIA HAUS
There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.
NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1417466152, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 58 is 60. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1417466152, enumerated as an "organization" on September 26, 2017.
The provider is located at 2741 45TH ST TWO RIVERS, WI 54241 and the phone number is (847) 612-0750.
Nursing Facility/Intermediate Care Facility with taxonomy code 313M00000X.
