MAHNOMEN HEALTH CENTER (NPI# 1366852402) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366852402 |
| Entity Type | Organization |
| Organization Name | MAHNOMEN HEALTH CENTER |
| Practice Address |
414 W Jefferson Ave Mahnomen MN 56557-4912 |
| Practice Telephone | 2189352511 |
| Practice Fax Number | 2189352370 |
| Mailing Telephone | 2189352511 |
| Mailing Fax Number | 2189352370 |
| Enumeration Date | 2014-04-29 |
| Last Update Date | 2015-05-06 |
| Authorized Official Name | MS. SUSAN KLASSEN (CEO) |
| Authorized Official Telephone | 2189359401 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | 369865 | MN | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | MN DEPT OF HEALTH LICENSE | 369865 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730114703 | Mahnomen Health Center | Medicare Defined Swing Bed Unit | 414 W Jefferson Ave, Mahnomen, MN 56557-4912 | 2006-07-11 |
| 1710912787 | Mahnomen Health Center | Skilled Nursing Facility | 414 W Jefferson Ave, Mahnomen, MN 56557-4912 | 2006-07-11 |
| 1942233234 | Mahnomen Health Center | General Acute Care Hospital | 414 W Jefferson Ave, Mahnomen, MN 56557-4912 | 2006-07-09 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MAHNOMEN HEALTH CENTER | 314 W Jefferson Ave, Mahnomen, MN 56557-4908 |
| Street Address |
414 W JEFFERSON AVE |
| City | MAHNOMEN |
| State | MN |
| Zip Code | 56557-4912 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144711276 | Ashley Marie Neis | Physical Therapist | 414 W Jefferson Ave, Mahnomen, MN 56557-4912 | 2018-05-24 |
| 1760574305 | Michael Parsons | Physical Therapist | 414 W Jefferson Ave, Mahnomen, MN 56557-4912 | 2006-09-29 |
| 1477654887 | Jesse Fuhrer | Physical Therapist | 414 W Jefferson Ave, Mahnomen, MN 56557-4912 | 2006-09-26 |
| 1730114703 | Mahnomen Health Center | Medicare Defined Swing Bed Unit | 414 W Jefferson Ave, Mahnomen, MN 56557-4912 | 2006-07-11 |
| 1710912787 | Mahnomen Health Center | Skilled Nursing Facility | 414 W Jefferson Ave, Mahnomen, MN 56557-4912 | 2006-07-11 |
| 1942233234 | Mahnomen Health Center | General Acute Care Hospital | 414 W Jefferson Ave, Mahnomen, MN 56557-4912 | 2006-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649755166 | Elizabeth Marie Engum | Nurse Practitioner | 410 North 4th Street, Mahnomen, MN 56557 | 2018-10-01 |
| 1184127474 | Anne Huschle | Health Educator | 785 Us Highway 59, Mahnomen, MN 56557 | 2018-03-13 |
| 1780120857 | Nicole Dyrdahl | Pharmacist | 211 South Main St, Mahnomen, MN 56557 | 2017-01-13 |
| 1417316902 | White Earth Band of Ojibwe | Community/Behavioral Health | 2515 Workforce Center Road, Mahnomen, MN 56557 | 2016-02-12 |
| 1114337268 | Mahnomen Area Assisted Living Center Inc | Assisted Living Facility | 314 West Jefferson Ave, Mahnomen, MN 56557 | 2014-04-29 |
| 1073955043 | Vanessa Diramos Gil | Student in an Organized Health Care Education/Training Program | 410 W 4th Street, Mahnomen, MN 56557 | 2013-07-19 |
| 1588746465 | Mahnomen Isd #432 | Local Education Agency (LEA) | 209 1st St Sw, Mahnomen, MN 56557 | 2006-10-19 |
| 1558463877 | White Earth Band of Chippewa | Substance Abuse Rehabilitation Facility | 2388 State Hwy 200, Mahnomen, MN 56557 | 2006-09-05 |
| 1992346373 | Brenda Geray | Registered Nurse | 211 S Main St, Mahnomen, MN 56557 | 2019-10-07 |
| 1871683714 | Thrifty Drug Stores Inc | Durable Medical Equipment & Medical Supplies | 211 South Main Street, Mahnomen, MN 56557 | 2006-10-13 |
| Find all providers in zip 56557 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
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| 1093315780 | Eco Green Corporation | Home Health | 3274 98th Cir N, Brooklyn Park, MN 55443-1846 | 2020-10-30 |
| 1841899846 | Hands On Care | Home Health | 1550 Larpenteur Ave W Apt 423, Falcon Heights, MN 55113-6364 | 2020-10-21 |
| 1326646191 | Rose Pratt | Home Health | 121 83rd Ave Ne Apt 310, Fridley, MN 55432-1893 | 2020-10-14 |
| 1255939369 | Mn Health LLC | Home Health | 784 Cougar Dr, Eagan, MN 55123-2069 | 2020-10-12 |
| 1942807672 | Twin Cities Group Homes LLC | Home Health | 711 22nd Ave Ne, Minneapolis, MN 55418-3601 | 2020-10-06 |
| 1801493721 | Shifaa Care Inc | Home Health | 7038 Brooklyn Blvd Unit D, Brooklyn Center, MN 55429-1370 | 2020-10-04 |
| 1841807450 | Shire Homecare Agency | Home Health | 618 9th Ave S Apt 307, Minneapolis, MN 55415-4608 | 2020-09-28 |
| Find all providers with the same taxonomy | ||||
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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.