# EXTENDICARE HOMES, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Cypress Grove Rehabilitation Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285707380
- **Authorized official:** DONNA JO MAASSEN (DIRECTOR OF COMPLIANCE)
- **Authorized official phone:** (414) 908-8119

## Contact information

- **Practice address:** 4255 MEDWEL DR, NEWBURGH, IN 47630-2528
- **Practice address phone:** (812) 853-2993
- **Practice address fax:** (812) 853-8845
- **Mailing address:** 111 W MICHIGAN ST, MILWAUKEE, WI 53203-2903
- **Mailing address phone:** (414) 908-8119
- **Mailing address fax:** (414) 908-7105

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | — | Yes |

## Other

- **Enumeration date:** 11/16/2006
- **Last updated:** 04/01/2008