MELLEN MANOR
NPI 1669403499
Skilled Nursing Facility in Mellen, WI

Active since July 06, 2006
450 LAKE DR, MELLEN, WI 54546(715) 274-5706(715) 274-2702 Get Directions Write a Review

NPPES record last updated: October 13, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 13, 2020, Oct 9, 2020, Aug 22, 2020 (3 updates tracked since 2020).

About Mellen Manor NPPES

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

MELLEN MANOR (NPI 1669403499) is a healthcare organization registered as a skilled nursing facility in Mellen, Wisconsin and active in the NPI registry since July 2006. The organization lists Jonathon Hansen, Ceo, as its authorized official.

NPPES Registry Identity

NPI1669403499
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameMELLEN MANOR LLC
Location Address450 LAKE DRMellen, WI 54546-9750
Mailing Address450 Lake DrMellen, WI 54546-9750 · (715) 274-5706 · Fax (715) 274-2702
Fax(715) 274-2702
Organization SubpartNo
Authorized OfficialJonathon HansenCeo · (320) 828-7310
Enumeration DateJuly 6, 2006
Last NPPES UpdateOctober 13, 20203 updates tracked since enumeration
NPPES CertifiedOctober 13, 2020
NPI 1669403499 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 · 314000000X
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.
450 LAKE DR, Mellen, WI 54546

Other Names 1

Doing Business AsMellen Manor

Other Identifiers 2

Medicaid100103573WI
Medicaid20120500WI

Other Providers at the Same Location NPPES 5

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

Occupational Therapy Assistant
450 LAKE DR
MELLEN, WI 54546
Occupational Therapy Assistant
450 LAKE DR
MELLEN, WI 54546
Physical Therapy Assistant
450 LAKE DR
MELLEN, WI 54546
Occupational Therapy Assistant
450 LAKE DR
MELLEN, WI 54546
Registered Nurse
450 LAKE DR
MELLEN, WI 54546

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 Mellen Manor LLC's NPI number?

The NPI number for Mellen Manor LLC is 1669403499. It was assigned to this organization in the NPPES registry on July 6, 2006. The provider is doing business as Mellen Manor.

Where is Mellen Manor LLC located?

Mellen Manor LLC is located at 450 Lake Dr, Mellen, WI 54546. The listed phone number is (715) 274-5706.

What is Mellen Manor LLC's specialty?

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

When was this NPI record last updated?

The NPPES record for Mellen Manor LLC was last updated on October 13, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.