Providence Villa

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

PROVIDENCE VILLA

Practice address

200 Minnesota Ave E
Sebeka, MN 56477-5002

Phone

(218) 837-9162

Fax

(218) 837-6861

NPI assigned

May 8, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Andrew Charles Huhta

Title

Owner

Phone

(218) 837-9162

Specialties & licenses 1

Addresses

Other names 1

• Providence Villa Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1525737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547596800000",
    "number": "1003305723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MINNESOTA AVE E",
            "city": "SEBEKA",
            "state": "MN",
            "postal_code": "564775002",
            "telephone_number": "218-837-9162",
            "fax_number": "218-837-6861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MINNESOTA AVE E",
            "city": "SEBEKA",
            "state": "MN",
            "postal_code": "564775002",
            "telephone_number": "218-837-9162",
            "fax_number": "218-837-6861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE VILLA",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-08",
        "last_updated": "2019-01-16",
        "status": "A",
        "authorized_official_last_name": "HUHTA",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "218-837-9162",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Providence Villa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kaylene Dewald
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• Up North Angels LLC
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• Wadena County
• Monica Watson, LICSW

• Assisted Living Facility in Sebeka, MN
• Providers in Sebeka, MN by specialty
• Assisted Living Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.