IMMANUEL LUTHERAN CORPORATION (NPI# 1649279183) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649279183 |
| Entity Type | Organization |
| Organization Name | IMMANUEL LUTHERAN CORPORATION |
| Other Organization Name | IMMANUEL LUTHERAN HOME |
| Practice Address |
185 Crestline Ave Kalispell MT 59901-3573 |
| Practice Telephone | 4067529622 |
| Practice Fax Number | 4067529615 |
| Mailing Telephone | 4067529622 |
| Mailing Fax Number | 4067529615 |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2010-12-20 |
| Authorized Official Name | MR. KEITH GENDREAU (ADMINSTRATOR.CEO) |
| Authorized Official Telephone | 4067529622 |
| Authorized Official Credential | LNHA CEO,CALA, F |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 10077 | MT | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MT | 0313300 | 05 | |
| MT | 0347815 | 05 | |
| MT | 0348023 | 05 | |
| MT | 0534430 | 05 | |
| MT | BCBS | 40632 | 01 |
| Other Name | Type Code |
|---|---|
| Immanuel Lutheran Home | Doing Business As Name - Organization |
| Street Address |
185 CRESTLINE AVE |
| City | KALISPELL |
| State | MT |
| Zip Code | 59901-3573 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740803527 | Sheila Cathleen Roche | Speech-Language Pathologist | 185 Crestline Ave, Kalispell, MT 59901-3573 | 2020-05-27 |
| 1548466832 | Barbara Lea Stewart | Physical Therapist | 185 Crestline Ave, Kalispell, MT 59901-3573 | 2007-06-22 |
| 1699979039 | Rhiana Renee Serna | Occupational Therapist | 185 Crestline Ave, Kalispell, MT 59901-3573 | 2007-06-11 |
| 1760685721 | Cara L Sargent | Occupational Therapist | 185 Crestline Ave, Kalispell, MT 59901-3573 | 2007-06-07 |
| 1538362637 | Glen Scott Sargent | Physical Therapist | 185 Crestline Ave, Kalispell, MT 59901-3573 | 2007-06-06 |
| 1194927582 | Linda Lee Stordahl | Physical Therapist | 185 Crestline Ave, Kalispell, MT 59901-3573 | 2007-06-05 |
| 1457554891 | Rhea Marie Hatfield | Speech-Language Pathologist | 185 Crestline Ave, Kalispell, MT 59901-3573 | 2007-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982226650 | Mountain Physical Therapy and Fitness Center LLC | Physical Medicine & Rehabilitation | 2593 Highway 2 East, Suite 6, Kalispell, MT 59901 | 2020-05-15 |
| 1164058350 | Jessica Leeann Abell | Physical Therapist | 1825 Highway 93 S. Suite C, Kalispell, MT 59901 | 2020-03-19 |
| 1588216535 | Diversified Therapeutic Services, Pllc | Clinic/Center | 30 E Washinton St, Suite A, Kalispell, MT 59901 | 2019-07-10 |
| 1467986216 | Jill Shaver | Counselor | 285 2nd Avenue Wn, Suite #100, Kalispell, MT 59901 | 2017-04-19 |
| 1003270810 | Angela Otto | Counselor | 17 2nd St E Ste 204, Kalispell, MT 59901 | 2016-04-07 |
| 1548626989 | Pamela Greskowiak | Counselor | 2282 Hwy 93 South, Suite #1, Kalispell, MT 59901 | 2016-01-14 |
| 1063894921 | Joel Booth | Dentist | 690 N Meridian Rd Ste 106, Kalispell, MT 59901 | 2015-06-26 |
| 1982085841 | Heather Reddig | Specialist | 751 Snowberry Trail, Kalispell, MT 59901 | 2015-06-16 |
| 1497147193 | Patricia Greene Hall | Psychologist | 1035 1st Ave W Fl 3, Kalispell, MT 59901 | 2015-03-04 |
| 1720478886 | Lori Mariani | Social Worker | 1605 Danielson Road, Kalispell, MT 59901 | 2015-01-28 |
| Find all providers in zip 59901 | ||||
| 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. |
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| 1124426283 | Genesis Rehabilitation | Skilled Nursing Facility | 1130 17 Th Ave South, Great Falls, MT 59405 | 2014-12-05 |
| 1336546811 | Empres At Lewistown, LLC | Skilled Nursing Facility | 410 Wendell Ave, Lewistown, MT 59457-2261 | 2014-11-26 |
| 1053728014 | Montana Vamc | Skilled Nursing Facility | 210 South Winchester, Miles City, MT 59301-4757 | 2014-07-22 |
| 1912189572 | Northeast Montana Health Services,inc | Skilled Nursing Facility | 1000 6th Ave N, Wolf Point, MT 59201-1828 | 2007-12-05 |
| 1205051729 | Elkhorn Health Care Inc | Skilled Nursing Facility | 474 Mt Highway 282, Clancy, MT 59634-9519 | 2007-04-17 |
| 1508990698 | Chouteau County District Hospital | Skilled Nursing Facility | 1501 St. Charles, Fort Benton, MT 59442 | 2007-03-14 |
| 1386790160 | Cnh Acquisitions Inc. | Skilled Nursing Facility | 3131 Amherst Ave, Butte, MT 59701-4653 | 2007-01-26 |
| 1942378534 | Memorial Hospital Association | Skilled Nursing Facility | 600 West 21st St, Red Lodge, MT 59068-0590 | 2006-12-01 |
| 1538248067 | Blackfeet Tribe | Skilled Nursing Facility | South Government Square, South Government Square, Browning, MT 59417-0728 | 2006-11-03 |
| 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.