NPIMap

Organization Active NPI

Lakeland Hospice, Inc.

Doing business as Lakeland Hospice and Home Care, Inc

  • Community Based Hospice Care Agency
  • Fergus Falls, MN
National Provider Identifier
1013910439
Registry record updated Mar 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
333817 Issued in MN
Legal business name
LAKELAND HOSPICE, INC.
Doing business as
Lakeland Hospice and Home Care, Inc
Practice address
1505 Pebble Lake Rd
Suite 400
Fergus Falls, MN 56537-3858
Phone
(218) 998-1400
Fax
(218) 998-1420
NPI assigned
May 31, 2005
Last updated
Mar 6, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2009

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

Authorized official

Name
Mrs. Cheryl L Pelaccio
Title
Administrator
Phone
(218) 998-1400

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 333772 MN
Community Based Hospice Care Agency 251G00000X 333817 MN Primary

Addresses

Primary practice location

1505 Pebble Lake Rd
Suite 400
Fergus Falls, MN 56537-3858

Mailing address

1505 Pebble Lake Rd
Suite 400
Fergus Falls, MN 56537-3858
Phone (218) 998-1400

Other identifiers 6

IdentifierTypeStateIssuer
59-00133OtherMNHOME CARE MEDICA
6J75LAOtherMNHOME CARE BCBS
50-25406OtherMNHOSPICE MEDICA
737565400MedicaidMN
777223800MedicaidMN
2Z97LAOtherMNHOSPICE BCBS

Other names 1

  • Lakeland Hospice and Home Care, Inc Doing business as

National Provider Directory

National Provider Directory

Locations

1505 Pebble Lake Rd
Ste 400
Fergus Falls, MN 56537
Phone (218) 998-1400

NPI Registry JSON

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236297600000",
    "number": "1013910439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 PEBBLE LAKE RD",
            "address_2": "SUITE 400",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565373858",
            "telephone_number": "218-998-1400",
            "fax_number": "218-998-1420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 PEBBLE LAKE RD",
            "address_2": "SUITE 400",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565373858",
            "telephone_number": "218-998-1400",
            "fax_number": "218-998-1420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKELAND HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-31",
        "last_updated": "2009-03-06",
        "status": "A",
        "authorized_official_last_name": "PELACCIO",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "218-998-1400",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MN",
            "license": "333772",
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "MN",
            "license": "333817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOME CARE MEDICA",
            "identifier": "59-00133",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOME CARE BCBS",
            "identifier": "6J75LA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOSPICE MEDICA",
            "identifier": "50-25406",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "737565400",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "777223800",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOSPICE BCBS",
            "identifier": "2Z97LA",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeland Hospice and Home Care, Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fergus Falls, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.