VIDELL HEALTHCARE CAMDEN, L.L.C. (CAMDEN CARE CENTER) - NPI NUMBER 1235482407

Summary

Provider Name: VIDELL HEALTHCARE CAMDEN, L.L.C. (CAMDEN CARE CENTER)

NPI Number: 1235482407

Clasification: Skilled Nursing Facility (314000000X)

Address:
512 49TH AVE N
MINNEAPOLIS, MN
ZIP 55430

Phone Number: (253) 277-3197



Detailed Information

VIDELL HEALTHCARE CAMDEN, L.L.C. is a skilled nursing facility in Minneapolis, MN. The provider is (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. The assigned NPI number for this provider is 1235482407 and is registered as an organization entity type.
The provider Is Doing Business As Camden Care Center.

The provider's business address is:

512 49TH AVE N
MINNEAPOLIS, MN
ZIP 55430-621
Phone: (253) 277-3197

The provider's authorized official is Stephen J. Laforte .
The authorized official title is Manager and has the following contact phone number (253) 277-3197.

The enumeration date for this NPI number is 10/24/2012 and was last updated on 4/19/2013.

Map - Location of Practice

Similar Providers

NPI Provider Name / Taxonomy
1073564308 GGNSC FRIDLEY LLC
Skilled Nursing Facility
1255424115 LONG TERM CARE SPECIALISTS INC
Skilled Nursing Facility
1346235181 MINNESOTA MASONIC HOME CARE CENTER
Skilled Nursing Facility
1477541282 AMERICAN BAPTIST HOMES OF THE MIDWEST
Skilled Nursing Facility
1588606461 LIFESPACE COMMUNITIES INC
Skilled Nursing Facility
1801899703 NORTH CITIES HEALTH CARE, INC
Skilled Nursing Facility

Taxonomy Codes

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 314000000X Skilled Nursing Facility Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 245544 MEDICARE OSCAR/CERTIFICATION MN

NPI Record

No. Field Name Field Value
1 NPI 1235482407
2 Entity Type Code 2
3 Employer Identification Number EIN
4 Provider Organization Name Legal Business Name VIDELL HEALTHCARE CAMDEN, L.L.C.
5 Provider Other Organization Name CAMDEN CARE CENTER
6 Provider Other Organization Name Type Code 3
7 Provider First Line Business Practice Location Address 512 49TH AVE N
8 Provider Business Practice Location Address City Name MINNEAPOLIS
9 Provider Business Practice Location Address State Name MN
10 Provider Business Practice Location Address Postal Code 554303621
11 Provider Business Practice Location Address Country Code If outside U S US
12 Provider Business Practice Location Address Telephone Number 2532773197
13 Provider Enumeration Date 10/24/2012
14 Last Update Date 4/19/2013
15 Authorized Official Last Name LAFORTE
16 Authorized Official First Name STEPHEN
17 Authorized Official Middle Name J.
18 Authorized Official Title or Position MANAGER
19 Authorized Official Telephone Number 2532773197
20 Healthcare Provider Taxonomy Code 1 314000000X
21 Healthcare Provider Primary Taxonomy Switch 1 Y
22 Other Provider Identifier 1 245544
23 Other Provider Identifier Type Code 1 06
24 Other Provider Identifier State 1 MN
25 Is Organization Subpart Y
26 Parent Organization LBN VIDELL HEALTHCARE, L.L.C.
27 Parent Organization TIN

Download Record

Download this NPI record in Text format: Export

Download this NPI record in Excel (CSV) format: Export

Download this NPI record in XML format: Export




This page was last updated on: 7/15/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.