COUNTRY MANOR CAMPUS LLC (NPI# 1942763313) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942763313 |
| Entity Type | Organization |
| Organization Name | COUNTRY MANOR CAMPUS LLC |
| Practice Address |
1200 Lanigan Way Sw Saint Joseph MN 56374-4732 |
| Mailing Address |
520 1st St Ne Sartell MN 56377-1274 |
| Practice Telephone | 3202533343 |
| Practice Fax Number | 3202400244 |
| Mailing Telephone | 3202588983 |
| Enumeration Date | 2019-04-11 |
| Last Update Date | 2019-04-11 |
| Authorized Official Name | KEVIN HARGUTH (C.F.O.) |
| Authorized Official Telephone | 3202588983 |
| Is Organization Subpart | Y |
| Parent Organization Name | COUNTRY MANOR CAMPUS LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | Agencies |
| Other Name | Type Code |
|---|---|
| Country Manor Extended Services - Woodcrest | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871767939 | Country Manor Campus LLC | Durable Medical Equipment & Medical Supplies | 520, 1st. St. Ne, Sartell, MN 56377-1274 | 2008-04-18 |
| 1760630214 | Country Manor Campus LLC | Non-emergency Medical Transport (VAN) | 520 1st St Ne, Sartell, MN 56377-1274 | 2008-09-08 |
| 1952575011 | Country Manor Campus LLC | Skilled Nursing Facility | 520 1st St Ne, Sartell, MN 56377-1274 | 2008-04-18 |
| 1497929558 | Country Manor Campus LLC | Durable Medical Equipment & Medical Supplies | 520 1st St Ne, Suite A, Sartell, MN 56377-1274 | 2008-04-18 |
| 1154595858 | Country Manor Campus LLC | Home Health | 520 1st St Ne, Sartell, MN 56377-1274 | 2008-04-15 |
| Street Address |
1200 LANIGAN WAY SW |
| City | SAINT JOSEPH |
| State | MN |
| Zip Code | 56374-4732 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083130488 | Bettin Counseling | Social Worker | 1151 Minnesota St E. #6, St Joseph, MN 56374 | 2017-08-17 |
| 1063949998 | Brian S Koltes | Chiropractor | 103 College Ave N, Saint Joseph, MN 56374 | 2017-05-23 |
| 1588102917 | Premier Healthcare Management of St Joseph LLC | Assisted Living Facility | 329 7th Ave Se, St. Joseph, MN 56374 | 2017-02-06 |
| 1720349608 | Laura Jayne Sherr | Counselor | 37 South College Avenue, C/o Csb Health Center, Lottie Hall Lower Level, St. Joseph, MN 56374 | 2012-06-06 |
| 1194084293 | Jamie Lane Vogt | Social Worker | 215 N. Benton Drive, Independent Lifestyles, Inc, Sauk Rapids, MN 56374 | 2012-05-09 |
| 1598979346 | Patricia Ann Martini | Psychologist | 100 West Minnesota St, St Joseph, MN 56374 | 2007-05-10 |
| 1982742144 | Phyllis Ann Owens | Psychologist | 211151 John Milless Drive, Rogers, MN 56374 | 2007-02-01 |
| 1043287527 | Carol L Holton | Nurse Practitioner | 37 College Ave South, Saint Joseph, MN 56374 | 2006-03-03 |
| 1265429542 | Gerard L Bobeldyk | Internal Medicine | 16472 Laurel Rd, St Joseph, MN 56374 | 2005-10-03 |
| 1780176602 | Jennifer Margaret Chirhart | Nurse Practitioner | 1360 Elm St E, Saint Joseph, MN 56374 | 2018-06-06 |
| Find all providers in zip 56374 | ||||
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730601030 | Diligent Healthcare LLC | Home Health | 4280 Laurel Dr, Saint Joseph, MI 49085-9360 | 2017-07-09 |
| 1740714765 | Cchc, LLC | Home Health | 2717 Morton Ave, Saint Joseph, MI 49085-2522 | 2017-04-17 |
| 1801135413 | Private Duty Home Healthcare, LLC | Home Health | 2626 Niles Ave, Saint Joseph, MI 49085-1938 | 2013-02-04 |
| 1891033239 | Sacred Heart Home Healthcare Inc | Home Health | 606 S Woodbine Rd, Saint Joseph, MO 64507-2186 | 2013-01-18 |
| 1619222395 | Freudenthal Home Health, LLC | Home Health | 3105 Frederick Ave Ste D, Saint Joseph, MO 64506-3074 | 2012-07-18 |
| 1578838900 | Help At Home, Inc | Home Health | 2409 N Woodbine Rd, Saint Joseph, MO 64506-3673 | 2012-03-19 |
| 1710203856 | Covenant Care LLC | Home Health | 2400 Frederick Ave Ste 507, Saint Joseph, MO 64506-2764 | 2010-04-14 |
| 1407087265 | Amedisys Michigan LLC | Home Health | 830 Pleasant St, Suite 316, Saint Joseph, MI 49085-2279 | 2009-07-28 |
| 1821295437 | Tender Care Inc. | Home Health | 6804 Ollmeda St, Saint Joseph, MO 64504-2632 | 2007-06-27 |
| 1073634911 | Freudenthal Home Health, LLC | Home Health | 3001 Frederick Ave, Suite A, Saint Joseph, MO 64506-2972 | 2007-04-02 |
| Find all providers in SAINT JOSEPH | ||||
| City | SAINT JOSEPH |
| Zip Code | 56374 |
Please comment or provide details below to improve the information on COUNTRY MANOR CAMPUS LLC.
| 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.