THE PROVIDENCE PLACE (NPI# 1578535886) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1578535886 |
Entity Type | Organization |
Organization Name | THE PROVIDENCE PLACE |
Practice Address |
3720 23rd Ave S Minneapolis MN 55407-3010 |
Practice Telephone | 6127245495 |
Enumeration Date | 2006-02-02 |
Last Update Date | 2020-08-22 |
Authorized Official Name | HOWIE GROFF (PRESIDENT) |
Authorized Official Telephone | 9528882923 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 314000000X | Skilled Nursing Facility | 328868 | MN | Nursing & Custodial Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MN | BCBS | 8810NI | 01 |
MN | MEDICA | 7100377 | 01 |
MN | HP | 62845 | 01 |
MN | MEDICA | 7122705 | 01 |
MN | UCARE | NH0131 | 01 |
Street Address |
3720 23RD AVE S |
City | MINNEAPOLIS |
State | MN |
Zip Code | 55407-3010 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1366996019 | Christina Cink | Occupational Therapy Assistant | 3720 23rd Ave S, Minneapolis, MN 55407-3010 | 2016-08-11 |
1770889487 | Covenire Care Nokomis, LLC - Dba The Waters of Minnehaha | Assisted Living Facility | 3720 23rd Ave S, Minneapolis, MN 55407-3010 | 2011-01-28 |
1851599021 | Senior Care Providence, LLC | Skilled Nursing Facility | 3720 23rd Ave S, Minneapolis, MN 55407-3010 | 2007-07-10 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1720644057 | Amana Home Care | Home Health | 2833 13th Ave S Suite 118, Minneapolis, MN 55407 | 2019-05-13 |
1356802979 | Aaron Randy Pickrel | Student in an Organized Health Care Education/Training Program | 2800 Chicago Avenue, #250, Minneapolis, MN 55407 | 2019-03-27 |
1053881631 | Naimo Abdisalam | Registered Nurse | 1229 East Lake Street, Minneapolis, MN 55407 | 2018-11-27 |
1437639614 | Kelly Usitalo | Nurse Practitioner | 913 E 26th Street, Piper Building Suite 401, Minneapolis, MN 55407 | 2018-08-17 |
1952880346 | Allison Hall | Internal Medicine | Minneapolis Heart Institute, 920 E 28 St. #300, Minneapolis, MN 55407 | 2018-08-07 |
1780176370 | Rebekah Sand | Physical Therapist | 2800 Chicage Avenue S, Suite 102, Minneapolis, MN 55407 | 2018-05-31 |
1417448663 | Vivian T.c. Liu | Student in an Organized Health Care Education/Training Program | 2020 E 28th Street, Suite 104, Minneapolis, MN 55407 | 2018-05-23 |
1053802397 | Isuroon | Counselor | 1600 East Lake Street Suite 1, Minneapolis, Mpls, MN 55407 | 2018-05-22 |
1154811404 | Mohamed Mukhtar Ali | Dentist | 4700 Cedar Ave S, Minneapolis, MN 55407 | 2018-05-12 |
1396254280 | Erin Elizabeth Casper | Registered Nurse | 3621 Oakland Ave, Minneapolis, MN 55407 | 2017-09-25 |
Find all providers in zip 55407 |
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 |
---|---|---|---|---|
1346841152 | Minneapolis Healthcare and Rehabilitation Center LLC | Skilled Nursing Facility | 815n Rothsay Street, Minneapolis, KS 67467 | 2020-11-06 |
1144707811 | Victory Health Operations, LLC | Skilled Nursing Facility | 512 - 49th Avenue North, Minneapolis, MN 55430-3621 | 2018-07-25 |
1457531949 | Hmong Skilled Services, Inc. | Skilled Nursing Facility | 2411 E Franklin Ave, Minneapolis, MN 55406-1026 | 2007-11-13 |
1831250976 | Voa Care Centers, Minnesota | Skilled Nursing Facility | 3245 Vera Cruz Ave N, Minneapolis, MN 55422-2708 | 2006-12-13 |
1073618997 | Bethany Covenant Home | Skilled Nursing Facility | 2309 Hayes St Ne, Minneapolis, MN 55418-3934 | 2006-09-14 |
1548211816 | Ggnsc Minneapolis Chateau LLC | Skilled Nursing Facility | 2106 2nd Ave S, Minneapolis, MN 55404-2606 | 2006-05-12 |
1023066867 | Augustana Chapel View Homes, Inc. | Skilled Nursing Facility | 1007 E 14th St, Minneapolis, MN 55404-1314 | 2006-05-04 |
1124019690 | Catholic Eldercare | Skilled Nursing Facility | 817 Main St Ne, Minneapolis, MN 55413-1931 | 2005-11-02 |
1619965365 | Redeemer Residence, Inc. | Skilled Nursing Facility | 625 W 31st St, Minneapolis, MN 55408-2922 | 2005-10-07 |
1477541282 | American Baptist Homes of The Midwest | Skilled Nursing Facility | 512 49th Ave N, Minneapolis, MN 55430-3621 | 2005-10-06 |
Find all providers in MINNEAPOLIS |
City | MINNEAPOLIS |
Zip Code | 55407 |
Please comment or provide details below to improve the information on THE PROVIDENCE PLACE.
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.