SENIOR CARE FOREST LAKE, LLC (NPI# 1114053113) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114053113 |
| Entity Type | Organization |
| Organization Name | SENIOR CARE FOREST LAKE, LLC |
| Other Organization Name | BIRCHWOOD HEALTH CARE CENTER |
| Practice Address |
604 N.e. First Street Forest Lake MN 55025 |
| Practice Telephone | 6514645600 |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2019-05-09 |
| Authorized Official Name | NANCY SUE RICHTER (ACCOUNTANT) |
| Authorized Official Telephone | 9528863268 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 332296 | MN | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | BCBS | 8608B | 01 |
| MN | HEALTHPARTNERS | HPFIN 231 | 01 |
| MN | UCARE | NH0004 | 01 |
| MN | 399240300 | 05 |
| Other Name | Type Code |
|---|---|
| Birchwood Health Care Center | Doing Business As Name - Organization |
| Street Address |
604 N.E. FIRST STREET |
| City | FOREST LAKE |
| State | MN |
| Zip Code | 55025 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043846173 | Persistence Physical Therapy LLC | Clinic/Center | 2009 W Broadway Ave, Ste 400 Pmb 131, Forest Lake, MN 55025 | 2020-03-20 |
| 1255973319 | Connie Rettig | Technician | 908 North Shore Drive, Forest Lake, MN 55025 | 2019-10-10 |
| 1003394479 | Malissa Ann Costanzo | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 844 8th Ave Se, Forest Lake, MN 55025 | 2018-07-30 |
| 1669754735 | Brent Alan Millard | Pharmacist | 1207 West Broadway Ave, Forest Lake, MN 55025 | 2011-09-15 |
| 1982842167 | Lakes Center for Youth and Families | Community/Behavioral Health | 20 N Lake Street, Suite 103, Forest Lake, MN 55025 | 2009-01-27 |
| 1487843355 | Paul Luke Mladnick | Marriage & Family Therapist | 1068 So Lake St, #109, Forest Lake, MN 55025 | 2007-10-17 |
| 1740477678 | Rita Lynn Scanlan | Occupational Therapist | 604 Ne 1st St, Birchwood Health Care Center, Forest Lake, MN 55025 | 2007-09-25 |
| 1073672101 | Catharine B Ruther | Dentist | 956 West Broadway, Lakes Dental Clinic, Forest Lake, MN 55025 | 2006-12-06 |
| 1407914849 | Ervin George Savord | Dentist | 255 Highway 97, Suite 1b, Forest Lake, MN 55025 | 2006-12-05 |
| 1609945286 | Elizabeth Anne Mcinerney | Social Worker | 882 Sw 15th Avenue, Forest Lake, MN 55025 | 2006-11-07 |
| Find all providers in zip 55025 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (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. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699074062 | Internal Medicine Consultants | Skilled Nursing Facility | 18811 Enfield Ave N, Forest Lake, MN 55025-9489 | 2011-03-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639707177 | Prairie Bluffs Rehabilitation Center LLC | Skilled Nursing Facility | 10300 Hennepin Town Rd, Eden Prairie, MN 55347-5100 | 2020-03-30 |
| 1881221869 | Natalie Sears | Skilled Nursing Facility | 1200 Cheri Ln Ne Apt 5, Fridley, MN 55421-1213 | 2020-03-26 |
| 1396210779 | Southview Operations LLC | Skilled Nursing Facility | 2000 Oakdale Avenue, West St. Paul, MN 55118 | 2018-10-11 |
| 1144707811 | Victory Health Operations, LLC | Skilled Nursing Facility | 512 - 49th Avenue North, Minneapolis, MN 55430-3621 | 2018-07-25 |
| 1710473434 | Cg Care Center, LLC. | Skilled Nursing Facility | 6993 80th Street South, Cottage Grove, MN 55016 | 2018-07-05 |
| 1457863466 | Seasons Healthcare of Trimont, Inc | Skilled Nursing Facility | 305 Broadway Avenue South, Trimont, MN 56176 | 2017-10-31 |
| 1760903157 | St. John's Lutheran Home | Skilled Nursing Facility | 1771 Eagle View Cir, Albert Lea, MN 56007-1817 | 2017-07-06 |
| 1114458221 | Lakeland Homecare LLC | Skilled Nursing Facility | 1604 Covington Ln, Eagan, MN 55122-2759 | 2017-03-22 |
| 1952842197 | Nsh Rochester East LLC | Skilled Nursing Facility | 501 8th Ave Se, Rochester, MN 55904-4834 | 2017-03-20 |
| 1750827234 | Walker Operations LLC | Skilled Nursing Facility | 209 Birchwood Avenue West, Walker, MN 56484 | 2017-01-09 |
| Find all providers with the same taxonomy | ||||
| City | FOREST LAKE |
| Zip Code | 55025 |
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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.