Red Wing Health Center, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

349026 Issued in MN

Legal business name

RED WING HEALTH CENTER, LLC

Practice address

1412 West 4TH Street
Red Wing, MN 55046

Phone

(651) 388-2843

Fax

(651) 388-9502

NPI assigned

Nov 17, 2005

Organization subpart

Yes

Parent organization

MISSION HEALTHCARE, LLCAs reported in NPPES

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

Authorized official

Name

Mr. Paul J. Contris

Title

President

Phone

(480) 730-1573

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Red Wing Health Center Doing business as

Part of

Welcov Healthcare LLC

Locations

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

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286236800000",
    "number": "1053393777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 WEST 4TH STREET",
            "city": "RED WING",
            "state": "MN",
            "postal_code": "55046",
            "telephone_number": "651-388-2843",
            "fax_number": "651-388-9502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 WEST 4TH STREET",
            "city": "RED WING",
            "state": "MN",
            "postal_code": "55046",
            "telephone_number": "651-388-2843",
            "fax_number": "651-388-9502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED WING HEALTH CENTER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MISSION HEALTHCARE, LLC",
        "enumeration_date": "2005-11-17",
        "last_updated": "2010-10-05",
        "status": "A",
        "authorized_official_last_name": "CONTRIS",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "480-730-1573",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MN",
            "license": "329002",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MN",
            "license": "349026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30395",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005315500",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "955270700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Red Wing Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Red Wing, MN
• Providers in Red Wing, MN by specialty
• Skilled Nursing Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2010; 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.