NPIMap

Organization Active NPI

Lutheran Social Service of Minnesota

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Le Roy, MN
National Provider Identifier
1073742383
Registry record updated Jul 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
License
1054398 Issued in MN
Legal business name
LUTHERAN SOCIAL SERVICE OF MINNESOTA
Practice address
198 Penny Lane
Leroy, MN 55951
Phone
(507) 342-3725
NPI assigned
Jul 8, 2009
Last updated
Jul 8, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2009

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

Authorized official

Name
Mr. Mark Peterson
Title
Ceo
Phone
(651) 642-5990

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X 1054398 MN Primary

Addresses

Primary practice location

198 Penny Lane
Leroy, MN 55951

Mailing address

2485 Como Ave
Saint Paul, MN 55108-1445

National Provider Directory

National Provider Directory
Tax ID family
Lutheran Social Service MN18 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1247011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247011200000",
    "number": "1073742383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2485 COMO AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551081445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "198 PENNY LANE",
            "city": "LEROY",
            "state": "MN",
            "postal_code": "55951",
            "telephone_number": "507-342-3725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUTHERAN SOCIAL SERVICE OF MINNESOTA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-08",
        "last_updated": "2009-07-08",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "651-642-5990",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "MN",
            "license": "1054398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Le Roy, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.