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HALSTAD LIVING CENTER NPI 1629066824


NPI Information

NPI: 1629066824
Provider Name: HALSTAD LIVING CENTER

Doing Business As: HALSTAD LIVING CENTER

Classification: Skilled Nursing Facility - 314000000X
Entity Type: Organization

CLIA Number: 24D0662969

Address:
133 4TH AVE E
HALSTAD, MN
ZIP 56548
Phone: (218) 456-2105
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HALSTAD LIVING CENTER is a skilled nursing facility in Halstad, 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. HALSTAD LIVING CENTER NPI is 1629066824. The provider is registered as an organization entity type.
The provider Is Doing Business As Halstad Living Center.

The provider's business location address is:

133 4TH AVE E
HALSTAD, MN
ZIP 56548-114
Phone: (218) 456-2105
Fax: (218) 456-2290

The provider's authorized official is Dwight A Fuglie .
The authorized official title is Executive Director and has the following contact phone number (218) 456-2105.

The CLIA number assigned to this NPI record is 24D0662969 - skilled nursing/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/11/2005 and was last updated on 3/22/2012.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1314000000XSkilled Nursing Facility328227MINNESOTAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1245569MEDICARE ID-TYPE UNSPECIFIEDMINNESOTA
2075740300MEDICAIDMINNESOTA
37122758OTHERMINNESOTAMEDICA INSURANCVE
49506 HAOTHERMINNESOTAMN BC-BS
530280MEDICAIDNORTH DAKOTA
623605OTHERNORTH DAKOTAND BLUE CROSS AND BLUE SH

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: 11/14/2023

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