AUGUSTANA MERCY CARE CENTER LLC (NPI# 1104143791) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104143791 |
| Entity Type | Organization |
| Organization Name | AUGUSTANA MERCY CARE CENTER LLC |
| Other Organization Name | AUGUSTANA KENWOOD PLACE |
| Practice Address |
710 S Kenwood Ave Moose Lake MN 55767-9405 |
| Practice Telephone | 2184854481 |
| Mailing Telephone | 2184854481 |
| Enumeration Date | 2010-04-23 |
| Last Update Date | 2019-10-21 |
| Authorized Official Name | SEELOCHANI STADTHERR (DIRECTOR OF REIMBURSEMENT) |
| Authorized Official Telephone | 9528555041 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | MN | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Augustana Kenwood Place | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528384310 | Augustana Mercy Care Center LLC | Skilled Nursing Facility | 710 S Kenwood Ave, Moose Lake, MN 55767-9405 | 2010-04-19 |
| Street Address |
710 S KENWOOD AVE |
| City | MOOSE LAKE |
| State | MN |
| Zip Code | 55767-9405 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164471108 | Arun J Shankar | Emergency Medicine | 710 S Kenwood Ave, Moose Lake, MN 55767-9405 | 2006-05-08 |
| 1962749358 | Urology Associates, Ltd | Urology | 710 S Kenwood Ave, Moose Lake, MN 55767-9405 | 2013-01-07 |
| 1528384310 | Augustana Mercy Care Center LLC | Skilled Nursing Facility | 710 S Kenwood Ave, Moose Lake, MN 55767-9405 | 2010-04-19 |
| 1023257789 | Lori Ann Ziehl | Occupational Therapist | 710 S Kenwood Ave, Moose Lake, MN 55767-9405 | 2009-02-19 |
| 1528212586 | Luann Joyce Charboneau | Physical Therapist | 710 S Kenwood Ave, Moose Lake, MN 55767-9405 | 2008-11-04 |
| 1851544290 | Richard Dean Jacobs | Physical Therapist | 710 S Kenwood Ave, Moose Lake, MN 55767-9405 | 2008-10-29 |
| 1063665503 | Ronald William Neva | Physical Therapist | 710 S Kenwood Ave, Moose Lake, MN 55767-9405 | 2008-10-28 |
| 1932352473 | Amy Michelle Oakes | Physical Therapist | 710 S Kenwood Ave, Moose Lake, MN 55767-9405 | 2008-10-28 |
| 1558514091 | Debra Kay Schuerman | Physical Therapist | 710 S Kenwood Ave, Moose Lake, MN 55767-9405 | 2008-10-28 |
| 1538346077 | Jeffrey Allen Schneider | Nurse Anesthetist, Certified Registered | 710 S Kenwood Ave, Moose Lake, MN 55767-9405 | 2008-01-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437778529 | Essentia Health Moose Lake | Home Health | 30 Arrowhead Ln, Moose Lake, MN 55767 | 2020-04-09 |
| 1841775475 | Katherine Mcdowell | Social Worker | 451 Arrowhead Lane, Moose Lake, MN 55767 | 2018-09-28 |
| 1316191786 | Vision Pro | Optometrist | 125 W Arrowhead Rd, Moose Lake, MN 55767 | 2008-11-11 |
| 1265627327 | Dr. Joseph J. Jamros Optometry, Ltd. | Optometrist | 312 Elm Ave., Moose Lake, MN 55767 | 2007-09-12 |
| 1013108075 | Diane Louise Stellrecht | Psychologist | 505 3rd Street, Suite A, Moose Lake, MN 55767 | 2007-08-06 |
| 1073674529 | Downtown Dental Care Pa | Dentist | 304 Elm Ave, Moose Lake, MN 55767 | 2006-12-12 |
| 1760558399 | Joseph John Jamros | Optometrist | 312 Elm Ave, Moose Lake, MN 55767 | 2006-11-27 |
| 1205909991 | Msocs-moose Lake | Intermediate Care Facility, Mentally Retarded | 305 4th St, Moose Lake, MN 55767 | 2006-11-17 |
| 1295804482 | Moose Lake Community Hospital District | Home Health | 30 Arrowhead Lane, Moose Lake, MN 55767 | 2006-11-06 |
| 1396770772 | Sonja M. Roach | Nurse Practitioner | 4570 County Highway 61, Moose Lake, MN 55767 | 2006-07-12 |
| Find all providers in zip 55767 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| 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. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720478407 | Augustana Oakview Care, LLC | Assisted Living Facility | 300 Talbot Dr, Moose Lake, MN 55767-5028 | 2015-02-02 |
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|---|---|---|---|---|
| 1871193417 | Midwest Group Home | Assisted Living Facility | 4232 5th St Ne, Columbia Heights, MN 55421-2860 | 2020-10-30 |
| 1710587696 | Friesen & Friesen, Inc | Assisted Living Facility | 1971 Ne 1st Avenue, Grand Rapids, MN 55744 | 2020-10-29 |
| 1750980603 | Estherra Care LLC | Assisted Living Facility | 1120 Morgan Ave N, Minneapolis, MN 55411-3805 | 2020-10-21 |
| 1679189682 | Daniel Care Homes LLC | Assisted Living Facility | 6809 Perry Ave N, Brooklyn Center, MN 55429-1611 | 2020-09-16 |
| 1326651779 | Secured Health and Homecare Inc | Assisted Living Facility | 4519 104th Ave N, Brooklyn Park, MN 55443-1030 | 2020-08-26 |
| 1811509870 | Aurora Assisted Living LLC | Assisted Living Facility | 115 Magnolia Ave W, Saint Paul, MN 55117-4916 | 2020-08-20 |
| 1003427477 | In My Father's House | Assisted Living Facility | 3096 Snelling Ave N, Roseville, MN 55113-1659 | 2020-08-11 |
| 1710595863 | Eden Prairie Senior Living | Assisted Living Facility | 8480 Franlo Rd, Eden Prairie, MN 55344-2938 | 2020-07-15 |
| 1447868468 | Brightstar Services LLC | Assisted Living Facility | 1821 University Ave W Ste 120, Saint Paul, MN 55104-2811 | 2020-07-15 |
| 1235757667 | Roers Senior Living Buffalo LLC | Assisted Living Facility | 150 Division Street East, Buffalo, MN 55313 | 2020-07-13 |
| Find all providers with the same taxonomy | ||||
| City | MOOSE LAKE |
| Zip Code | 55767 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.