VILLA ST. VINCENT NPI 1215932728

NPI Information

  • NPI: 1215932728
  • Provider Name: VILLA ST. VINCENT
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • CLIA Number: 24D0701604
  • Address: 516 WALSH ST
    CROOKSTON, MN
    ZIP 56716
  • Phone: (218) 281-3424

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NPI Details

VILLA ST. VINCENT is an assisted living facility in Crookston, 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. VILLA ST. VINCENT NPI is 1215932728. The provider is registered as an organization entity type.

The provider's business location address is:

516 WALSH ST
CROOKSTON, MN
ZIP 56716
Phone: (218) 281-3424
Fax: (218) 281-4755

The provider's authorized official is Judy Hulst .
The authorized official title is Ceo/administrator and has the following contact phone number (218) 281-9700.

The CLIA number assigned to this NPI record is 24D0701604 - skilled nursing facility/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/21/2005 and was last updated on 10/23/2013.

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
1314000000XSkilled Nursing Facility328575MINNESOTANo
2314000000XSkilled Nursing Facility352789MINNESOTANo
3310400000XAssisted Living Facility353890MINNESOTANo
4310400000XAssisted Living Facility325662MINNESOTAYes

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
1245484MEDICARE ID-TYPE UNSPECIFIEDMINNESOTAMEDICARE PROVIDER NUMBER
21215932728MEDICARE UPIN
38756VIOTHERMINNESOTABLUE CROSS INSURANCE
4177240600MEDICAIDMINNESOTA
5=========OTHERMINNESOTAFEDERAL I D

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: 11/21/2025

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