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LUTHERAN SOCIAL SERVICE OF MINNESOTA NPI 1255797718


NPI Information

NPI: 1255797718
Provider Name: LUTHERAN SOCIAL SERVICE OF MINNESOTA
Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Organization

CLIA Number: 24D0702038

Address:
497 GATES AVE NW
ELK RIVER, MN
ZIP 55330
Phone: (651) 310-9451
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LUTHERAN SOCIAL SERVICE OF MINNESOTA is an intermediate care facility mentally retarded in Elk River, MN. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. LUTHERAN SOCIAL SERVICE OF MINNESOTA NPI is 1255797718. The provider is registered as an organization entity type.

The provider's business location address is:

497 GATES AVE NW
ELK RIVER, MN
ZIP 55330-633
Phone: (651) 310-9451

The provider's authorized official is Brigid Peterson .
The authorized official title is Chief Compliance & Integration and has the following contact phone number (651) 310-9451.

The CLIA number assigned to this NPI record is 24D0702038 - intermediate care facility for mentally retarded with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/13/2016 and was last updated on 1/13/2016.


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
1315P00000XIntermediate Care Facility, Intellectual DisabilitiesYes

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

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