BENEDICTINE CARE CENTERS NPI 1730264607

NPI Information

NPI: 1730264607
Provider Name: BENEDICTINE CARE CENTERS

Doing Business As: ST. CRISPIN LIVING COMMUNITY - THE VILLA

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization

Address:
213 PIONEER RD
RED WING, MN
ZIP 55066
Phone: (651) 388-1234
Get Directions

BENEDICTINE CARE CENTERS is an assisted living facility in Red Wing, MN. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. BENEDICTINE CARE CENTERS NPI is 1730264607. The provider is registered as an organization entity type.
The provider Is Doing Business As St. Crispin Living Community - The Villa.

The provider's business location address is:

213 PIONEER RD
RED WING, MN
ZIP 55066-921
Phone: (651) 388-1234
Fax: (651) 385-5444

The provider's authorized official is Jake Goering .
The authorized official title is Administrator/ceo and has the following contact phone number (651) 385-3435.

The CLIA number assigned to this NPI record is 24D0915735 - skilled nursing facility/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/26/2006 and was last updated on 6/14/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	310400000X	Assisted Living Facility		331733	MINNESOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	377175000	MEDICAID	MINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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