Ecumen

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

356845 Issued in MN

Legal business name

ECUMEN

Doing business as

Emmanuel Nursing Home

Practice address

600 S Davis Ave
Litchfield, MN 55355-3431

Phone

(320) 693-2472

Fax

(320) 693-2242

NPI assigned

Jul 29, 2006

Last updated

Nov 8, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Scott R Riddle

Title

VP of Finance

Phone

(651) 766-4300

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• Emmanuel Nursing Home Doing business as

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352332800000",
    "number": "1104830546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3530 LEXINGTON AVE N",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "551268166",
            "telephone_number": "651-766-4300",
            "fax_number": "651-766-4479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S DAVIS AVE",
            "city": "LITCHFIELD",
            "state": "MN",
            "postal_code": "553553431",
            "telephone_number": "320-693-2472",
            "fax_number": "320-693-2242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ECUMEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-29",
        "last_updated": "2012-11-08",
        "status": "A",
        "authorized_official_last_name": "RIDDLE",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "651-766-4300",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MN",
            "license": "356845",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "31895",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "NH0033",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "134543500",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8766EM",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIME WEST",
            "identifier": "03080201701",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "7122534",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Emmanuel Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amber Dee Cziok, D.D.S.
• Michael George Cziok, D.D.S.
• Jeanette Lynn Davis
• Janet Day, BS PHARMACY
• Carly Ann Derouin, MOT, OTR/L, CLT
• Ecumen (Ecumen Home Care - Litchfield)
• Ecumen (Ecumen Litchfield Adult Day Services)
• Ecumen (Bethany Assisted Living in Litchfield)
• Ecumen (Emmaus Place)
• Jennifer Engel, LMFT

• Skilled Nursing Facility in Litchfield, MN
• Providers in Litchfield, 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 Nov 8, 2012; 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.