OUR LADY OF PEACE (NPI# 1710352869) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710352869 |
| Entity Type | Organization |
| Organization Name | OUR LADY OF PEACE |
| Other Organization Name | OUR LADY OF PEACE HOME |
| Practice Address |
2076 Saint Anthony Ave Saint Paul MN 55104-4543 |
| Practice Telephone | 6517895031 |
| Enumeration Date | 2015-12-01 |
| Last Update Date | 2015-12-01 |
| Authorized Official Name | JOSEPH STANISLAV (CEO) |
| Authorized Official Telephone | 6517895031 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315D00000X | Hospice, Inpatient | 375345 | MN | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Our Lady of Peace Home | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598751869 | Our Lady of Peace | Registered Nurse | 2076 St Anthony Ave, St Paul, MN 55104-5028 | 2005-09-22 |
| 1366989139 | Our Lady of Peace | Home Health | 2076 Saint Anthony Ave, Saint Paul, MN 55104-4543 | 2017-01-31 |
| 1871580530 | Our Lady of Peace | Registered Nurse | 2076 St Anthony Ave, St Paul, MN 55104-5028 | 2005-09-28 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | OUR LADY OF PEACE INC. | 3333 Peters Creek Rd Nw, Roanoke, Virginia 24019-2719 |
| System for Award Management (SAM) Entities | OUR LADY OF PEACE SCHOOL | 709 Plainfield Rd, Darien, IL 60561-4213 |
| New York State Corporations | OUR LADY OF PEACE, INC. | 80 State Street, Albany, New York 12207-2543 |
| Street Address |
2076 SAINT ANTHONY AVE |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55104-4543 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689600751 | Nancy Jean Baker | Family Medicine | 2076 Saint Anthony Ave, Saint Paul, MN 55104-4543 | 2006-06-23 |
| 1366989139 | Our Lady of Peace | Home Health | 2076 Saint Anthony Ave, Saint Paul, MN 55104-4543 | 2017-01-31 |
| 1710074232 | Michael E Pinchback | Family Medicine | 2076 Saint Anthony Ave, Saint Paul, MN 55104-4543 | 2006-10-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891339131 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 1600 University Ave West, Suite 12, Room P, Saint Paul, MN 55104 | 2019-10-30 |
| 1629541644 | Michael P Cain | Counselor | 1821 University Ave West, Suite N385, St. Paul, MN 55104 | 2019-01-03 |
| 1295219657 | Awaken Recovery Center L.l.c | Counselor | 400 Suite D 393 North Dunlap, St Paul, MN 55104 | 2018-09-21 |
| 1285115634 | American Current Care of Minnesota PC | Clinic/Center | 570 Asbury St Ste 101, Saint Paul, MN 55104 | 2018-08-23 |
| 1699262501 | B & M Vital Homecare LLC. | Home Health | 1821 University Ave., W., Ste #s334, St. Paul, MN 55104 | 2018-04-16 |
| 1134621600 | Lauren Fullerton | Counselor | 1821 University Ave W., Suite N385, St. Paul, MN 55104 | 2018-03-01 |
| 1265944672 | Megan Manning | Marriage & Family Therapist | 475 Cleveland Ave. N., Suite 316, St. Paul, MN 55104 | 2017-10-26 |
| 1801305131 | Foncham Buma Foncham | Registered Nurse | 856 University Avenue, W, St. Paul, MN 55104 | 2017-09-29 |
| 1750802476 | Ha Vo | Counselor | 451 Lexington Parkway North, St. Paul, MN 55104 | 2017-07-03 |
| 1952831026 | Noble Senior Center Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1094 University Ave W, Saint Paul, MN 55104 | 2017-06-12 |
| Find all providers in zip 55104 | ||||
| Taxonomy Code | 315D00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Hospice, Inpatient |
| A provider organization, or distinct part of the organization, which renders an interdisciplinary program providing palliative care, chiefly medical relief of pain and supporting services, which addresses the emotional, social, financial, and legal needs of terminally ill patients and their families where an institutional care environment is required for the patient. |
| Notes: Source: AHA Guide, American Hospital Association. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114094620 | Healthpartners Rc | Hospice, Inpatient | 100 Healthy Way, Olivia, MN 56277-1117 | 2006-11-29 |
| 1902988868 | Rice County District One Hospital | Hospice, Inpatient | 200 State Ave, Faribault, MN 55021-6339 | 2006-10-19 |
| 1407962335 | Pipestone County Medical Center | Hospice, Inpatient | 916 4th Ave Sw, Pipestone, MN 56164-1890 | 2006-08-22 |
| City | SAINT PAUL |
| Zip Code | 55104 |
Please comment or provide details below to improve the information on OUR LADY OF PEACE.
| 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.