Active NPI
Michael Manu
- Adult Care Home Facility
- Fergus Falls, MN
National Provider Identifier
1053289470
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Care Home Facility
- License
- 1129018
- Practice address
- 906 S Martin St
Fergus Falls, MN 56537-3248 - Phone
- (346) 324-1346
- NPI assigned
- Oct 27, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Care Home Facility | 311ZA0620X | 1129018 | MN | Primary |
Addresses
Primary practice location
906 S Martin St
Fergus Falls, MN 56537-3248
Mailing address
906 S Martin St
Fergus Falls, MN 56537-3248
Phone (346) 324-1346
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1129018 | MN | MD | Adult Care Home Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1761523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761523200000",
"number": "1053289470",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "906 S MARTIN ST",
"city": "FERGUS FALLS",
"state": "MN",
"postal_code": "565373248",
"telephone_number": "346-324-1346"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "906 S MARTIN ST",
"city": "FERGUS FALLS",
"state": "MN",
"postal_code": "565373248",
"telephone_number": "346-324-1346"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANU",
"first_name": "MICHAEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-10-27",
"last_updated": "2025-10-27",
"certification_date": "2025-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "311ZA0620X",
"taxonomy_group": "",
"desc": "Custodial Care Facility, Adult Care Home",
"state": "MN",
"license": "1129018",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Oct 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.