INGLESIDE MANOR
NPI 1518213222
Skilled Nursing Facility in Mount Horeb, WI

Active since July 31, 2012CLIA 52D0881426 · Waiver
407 N 8TH ST, MOUNT HOREB, WI 53572(608) 437-5511(608) 437-9603 Get Directions Write a Review

NPPES record last updated: October 13, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Ingleside Manor NPPES

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

INGLESIDE MANOR (NPI 1518213222) is a healthcare organization registered as a skilled nursing facility in Mount Horeb, Wisconsin and active in the NPI registry since July 2012. The organization holds a CLIA Waiver certificate valid through January 10, 2028 and lists Stephanie Sherman, Chief Operation Officer, as its authorized official.

NPPES Registry Identity

NPI1518213222
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameWISCONSIN ILLINOIS SENIOR HOUSING, INC.
Location Address407 N 8TH STMount Horeb, WI 53572-1872
Mailing Address407 N 8th StMount Horeb, WI 53572-1872 · (608) 437-5511 · Fax (608) 437-9603
Fax(608) 437-9603
Organization SubpartNo
Authorized OfficialStephanie ShermanChief Operation Officer · (303) 980-0611
Enumeration DateJuly 31, 2012
Last NPPES UpdateOctober 13, 2021
NPPES CertifiedOctober 13, 2021
NPI 1518213222 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 · 2287
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.
407 N 8TH ST, Mount Horeb, WI 53572

Other Names 1

Doing Business AsIngleside Manor

Other Identifiers 1

Medicaid1518213222WI

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 52D0881426

Ingleside Manor · Mount Horeb, WI
Active · expires Jan 10, 2028
CLIA Number52D0881426
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateJanuary 11, 2026
Certificate Expiration DateJanuary 10, 2028
Laboratory DirectorMs. Donna M. Kruchten
Laboratory Phone(608) 437-5511
Laboratory LocationIngleside Manor407 N 8th, Mount Horeb, WI 53572
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 13

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

Nurse Practitioner
407 N 8TH ST
MOUNT HOREB, WI 53572
Occupational Therapist
407 N 8TH ST
MOUNT HOREB, WI 53572
Occupational Therapist
407 N 8TH ST
MOUNT HOREB, WI 53572
Physical Therapist
407 N 8TH ST
MOUNT HOREB, WI 53572
Physical Therapist
407 N 8TH ST
MOUNT HOREB, WI 53572
Speech-Language Pathologist
407 N 8TH ST
MOUNT HOREB, WI 53572
Physical Therapy Assistant
407 N 8TH ST
MOUNT HOREB, WI 53572
Physical Therapy Assistant
407 N 8TH ST
MOUNT HOREB, WI 53572

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 Wisconsin Illinois Senior Housing, Inc.'s NPI number?

The NPI number for Wisconsin Illinois Senior Housing, Inc. is 1518213222. It was assigned to this organization in the NPPES registry on July 31, 2012. The provider is doing business as Ingleside Manor.

Where is Wisconsin Illinois Senior Housing, Inc. located?

Wisconsin Illinois Senior Housing, Inc. is located at 407 N 8th St, Mount Horeb, WI 53572. The listed phone number is (608) 437-5511.

What is Wisconsin Illinois Senior Housing, Inc.'s specialty?

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

Does Wisconsin Illinois Senior Housing, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 52D0881426) is associated with this NPI, valid through January 10, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Wisconsin Illinois Senior Housing, Inc. was last updated on October 13, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.