NPIMap

Organization Active NPI

Glenwood Village Care Center Inc

  • Skilled Nursing Facility
  • Glenwood, MN
National Provider Identifier
1063409647
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
GLENWOOD VILLAGE CARE CENTER INC
Practice address
719 2ND St SE
Glenwood, MN 56334-1810
Phone
(320) 634-5131
Fax
(320) 634-5777
NPI assigned
Sep 29, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

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

Authorized official

Name
Marnie Marie Gugisberg
Title
Cfo
Phone
(320) 763-1164

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X MN Primary

Addresses

Primary practice location

719 2ND St SE
Glenwood, MN 56334-1810

Mailing address

719 2ND St SE
Glenwood, MN 56334-1810
Phone (320) 634-5131

Other identifiers 5

IdentifierTypeStateIssuer
0309130901OtherMNPRIMEWEST
9622GLOtherMNBLUE CROSS OF MN
030913090OtherMNPRIMEWEST
71-22756OtherMNMEDICA
938342500MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20021008000036 MN Part A Provider - Skilled Nursing Facility 8123935764 Practice locations: Glenwood, MN

Skilled nursing facility certification: CCN 245402

Legal name
GLENWOOD VILLAGE CARE CENTER INC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Dec 1, 1986
Last certification
May 21, 2025
Beds
64
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Incorporated
Dec 10, 1963 in MN
Enrollment address
719 2ND St SE
Glenwood, MN 56334-1810
Nursing home name
GLENWOOD VILLAGE CARE CENTER
Affiliated entity
VIVIE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Glenwood Village Care CenterCCN 245402
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
3 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Dec 1, 1986
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6458.3 residents per day on average
Chain
Vivie5 facilities in the chain
Penalties (3 years)
1Fines totaling $15,592

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D0671126Glenwood Village Care Center719 SE 2ND Street, Glenwood, MN 56334Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Glenwood Village Care Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

719 2nd St SE
Glenwood, MN 56334
Phone (320) 634-5131

Ownership & related parties

All disclosed owners & managing parties 11

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Sharon Braaten Individual Corporate DirectorDirector Mar 1, 2022
Allen Dahlseng Individual Corporate DirectorDirector Mar 1, 2022
Angela Mae Urman Individual Operational/Managerial ControlChief Clinical Officer Oct 10, 2022
Thomas Talle Individual Corporate DirectorDirector Mar 3, 2013
Douglas Bogie Individual Corporate DirectorDirector Mar 5, 2017
Bill Jason Garcia Individual Operational/Managerial ControlExecutive Director Jan 23, 2023
Sharon Isdahl Individual Corporate DirectorDirector Mar 4, 2012
Knute Nelson Organization, Alexandria, MN Corporation, Non-profit Operational/Managerial Control Oct 10, 2022 100%
Marnie Marie Gugisberg Individual Corporate OfficerChief Financial Officer Oct 10, 2022
Operational/Managerial ControlChief Financial Officer Oct 10, 2022
Laura Jergenson Individual Corporate DirectorDirector Oct 29, 2015
Jodi McGinty Individual Corporate DirectorDirector Mar 1, 2021

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 4

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 4

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712880000000",
    "number": "1063409647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 2ND ST SE",
            "city": "GLENWOOD",
            "state": "MN",
            "postal_code": "563341810",
            "telephone_number": "320-634-5131",
            "fax_number": "320-634-5777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 2ND ST SE",
            "city": "GLENWOOD",
            "state": "MN",
            "postal_code": "563341810",
            "telephone_number": "320-634-5131",
            "fax_number": "320-634-5777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENWOOD VILLAGE CARE CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-29",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A",
        "authorized_official_last_name": "GUGISBERG",
        "authorized_official_first_name": "MARNIE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "320-763-1164"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIMEWEST",
            "identifier": "0309130901",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF MN",
            "identifier": "9622GL",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIMEWEST",
            "identifier": "030913090",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "71-22756",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "938342500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenwood, MN

Sources for this page

Verify at the official NPI Registry.