NPIMap

Organization Active NPI

Lutheran Social Service of Minnesota

  • Intellectual Disabilities Intermediate Care Facility
  • Elk River, MN
National Provider Identifier
1114385085
Registry record updated Feb 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
LUTHERAN SOCIAL SERVICE OF MINNESOTA
Practice address
11754 191 1/2 Ave NW
Elk River, MN 55330-1367
Phone
(651) 310-9451
NPI assigned
Feb 5, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2017

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

Authorized official

Name
Ms. Brigid Peterson
Title
Chief Compliance & Integration
Phone
(651) 310-9451

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X Primary

Addresses

Primary practice location

11754 191 1/2 Ave NW
Elk River, MN 55330-1367

Mailing address

2485 Como Ave
Saint Paul, MN 55108-1445
Phone (800) 582-5260

National Provider Directory

National Provider Directory
Tax ID family
Lutheran Social Service18 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": "1454630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487894400000",
    "number": "1114385085",
    "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",
            "telephone_number": "800-582-5260",
            "fax_number": "651-969-2350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11754 191 1/2 AVE NW",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553301367",
            "telephone_number": "651-310-9451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUTHERAN SOCIAL SERVICE OF MINNESOTA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-05",
        "last_updated": "2017-02-24",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "BRIGID",
        "authorized_official_title_or_position": "CHIEF COMPLIANCE & INTEGRATION",
        "authorized_official_telephone_number": "651-310-9451",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk River, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2017; 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.