Augustana Mercy Care Center LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

AUGUSTANA MERCY CARE CENTER LLC

Practice address

710 S Kenwood Ave
Moose Lake, MN 55767-9405

Phone

(218) 485-4481

NPI assigned

Apr 23, 2010

Organization subpart

No

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

Authorized official

Name

Seelochani Stadtherr

Title

Avp, Revenue Cycle Management

Phone

(952) 855-5041

Specialties & licenses 1

Addresses

Other names 2

• Augustana Kenwood Place Doing business as
• Moose Lake Village Assisted Living - Kenwood Doing business as

Tax ID family

Augustana Care Moose Lake Health Rehab2 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.

• Augustana Mercy Care Center LLC

  • Skilled Nursing Facility
  • Moose Lake, MN
  • NPI 1528384310
  NPD tax ID

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

{
    "created_epoch": "1271980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784764800000",
    "number": "1104143791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7171 OHMS LN",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554392142",
            "telephone_number": "952-855-5041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 S KENWOOD AVE",
            "city": "MOOSE LAKE",
            "state": "MN",
            "postal_code": "557679405",
            "telephone_number": "218-485-4481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUGUSTANA MERCY CARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-23",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A",
        "authorized_official_last_name": "STADTHERR",
        "authorized_official_first_name": "SEELOCHANI",
        "authorized_official_title_or_position": "AVP, REVENUE CYCLE MANAGEMENT",
        "authorized_official_telephone_number": "952-855-5041"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Augustana Kenwood Place",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Augustana Kenwood Place",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Moose Lake Village Assisted Living - Kenwood",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Megyn Kolleen Albrecht, PHARMD
• Nicholas T Allard, PT
• Andrew Ames, M.D.
• Melissa Jean Anderson, MA
• Augustana Mercy Care Center LLC
• Augustana Oakview Care, LLC
• Kristina Bailey
• Sharyn Barney, M.D.
• John Sutherland Barry, M.D.

• All providers in Moose Lake, MN
• Assisted Living Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2026; 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.