Active NPI
Koochiching Health Services
Doing business as Jack Pine Chateau
- Assisted Living Facility
- Littlefork, MN
National Provider Identifier
1063870129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- Legal business name
- KOOCHICHING HEALTH SERVICES
- Doing business as
- Jack Pine Chateau
- Practice address
- 912 Main St
Littlefork, MN 56653-9357 - Phone
- (218) 278-6634
- Fax
- (218) 278-6637
- NPI assigned
- Feb 4, 2016
- Last updated
- Feb 5, 2025
- Organization subpart
- Yes
- Parent organization
- ST FRANCIS HEALTH SERVICES OF MORRIS INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Curtis Bach
- Title
- Cfo
- Phone
- (320) 589-4910
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | NU | Primary |
Addresses
Primary practice location
912 Main St
Littlefork, MN 56653-9357
Mailing address
801 Nevada Ave Ste 100
Morris, MN 56267-1874
Phone (320) 589-2004
Other names 1
- Jack Pine Chateau
National Provider Directory
National Provider Directory- Tax ID family
- Jack Pine Chateau
- Part of
- St Francis Health Services of Morris Inc
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Littlefork Care Center
- Skilled Nursing Facility
- Littlefork, MN
- NPI 1609233980
-
dba Littlefork Medical Center
- Non-emergency Medical Transport (VAN)
- Littlefork, MN
- NPI 1295879906
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1454544000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1738713600000",
"number": "1063870129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "801 NEVADA AVE STE 100",
"city": "MORRIS",
"state": "MN",
"postal_code": "562671874",
"telephone_number": "320-589-2004",
"fax_number": "320-589-2543"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "912 MAIN ST",
"city": "LITTLEFORK",
"state": "MN",
"postal_code": "566539357",
"telephone_number": "218-278-6634",
"fax_number": "218-278-6637"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KOOCHICHING HEALTH SERVICES",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "ST FRANCIS HEALTH SERVICES OF MORRIS INC",
"enumeration_date": "2016-02-04",
"last_updated": "2025-02-05",
"certification_date": "2025-02-05",
"status": "A",
"authorized_official_last_name": "BACH",
"authorized_official_first_name": "CURTIS",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "320-589-4910"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Jack Pine Chateau",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Littlefork, MN
- Paul David Havens, MD
- Ind School Dist 362
- International Falls Memorial Hospital Association (Rainy Lake Medical Center)
- International Falls Memorial Hospital Association (Rainy Lake Clinic - Littlefork)
- Heather Lynn Juen, PT
- Koochiching Health Services (Littlefork Care Center)
- Hannah Lydia Larson, MS, CCC-SLP
- Littlefork Municipal Hospital (Littlefork Medical Center)
- Littlefork Municipal Hospital (Littlefork Jackpine Chateau)
- Littlefork Municipal Hospital (Pineview Recovery Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 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.