Community Memorial Hospital & Nursing Home
Organization Active NPI Skilled Nursing Facility · Spring Valley, MN
NPI 1124025812 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1124025812
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- Legal business name
- COMMUNITY MEMORIAL HOSPITAL & NURSING HOME
- Practice address
- 800 Memorial Dr
Spring Valley, MN 55975-1024 - Phone
- (507) 346-7381
- Fax
- (507) 346-7619
- NPI assigned
- Jul 7, 2005
- Organization subpart
- No
Authorized official
- Name
- Penny Solberg, MBA
- Title
- Administrator
- Phone
- (507) 346-7381
Owners & managing parties with NPI records 1
Practitioners 1
Affiliated clinicians 2
-
Cory A Boyce, MD
Medicare Care Compare: Nursing home
- Listed as
- Spring Valley Care Center
- Overall star rating
- ★★★☆☆ 3 of 5
- Health inspections
- ★★★☆☆ 3 of 5
- Staffing
- ★★★☆☆ 3 of 5
- Quality measures
- ★★★★☆ 4 of 5
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Mar 1, 1987
- Medicare certification status
- Active
- Certified beds
- 45 · 42.7 residents per day on average
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Skilled nursing facility certification: CCN 245442
- Legal name
- COMMUNITY MEMORIAL HOSPITAL & NURSING HOME
- Doing business as
- SPRING VALLEY LIVING
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Mar 1, 1987
- Last certification
- Nov 21, 2024
- Beds
- 45
- Ownership / control type
- Nonprofit Corporation
- Organization structure
- Corporation · Non-profit
- Enrollment address
- 800 Memorial Dr
Spring Valley, MN 55975-1054 - Nursing home name
- SPRING VALLEY CARE CENTER
All disclosed owners & managing parties 4
| Name | Role | Since | Share |
|---|---|---|---|
| Tracie Mensink |
Corporate Director |
Jan 25, 2018 | |
| Lilia C Ponton |
Operational/Managerial Control | Dec 1, 2024 | |
| Adp of the SNF | Dec 1, 2024 | ||
| Luann Ruesink |
Corporate Director |
Feb 20, 2020 | |
| Heather R Sellers |
Corporate Officer |
Dec 1, 2024 | |
| Operational/Managerial Control | Dec 1, 2024 | ||
| Adp of the SNF | Dec 1, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20091216000065 | MN | Part a Provider - Skilled Nursing Facility | 2163562562 | Practice locations: Spring Valley, MN |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | MN | Yes |
Addresses
Primary practice location
800 Memorial Dr
Spring Valley, MN 55975-1024
Mailing address
800 Memorial Dr
Spring Valley, MN 55975-1024
Phone (507) 346-7381
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7Z16SP | Other | MN | BLUE CROSS BLUE SHIELD |
| NH0282 | Other | MN | UCARE |
| 046545300 | Medicaid | MN | |
| 5C61SP | Other | MN | BCBS HOME HEALTH |
Other names
- Spring Valley Senior Living
Other providers in Spring Valley, MN
- Chisom O Bruns
- Keith Casella
- Cindy Powell Therapy & Consulting LLC
- City of Spring Valley
- Community Memorial Hospital & Nursing Home
- Community Memorial Hospital & Nursing Home
- Jason Fuah
- Michael W Gordon
- Jessica Gorr
- Brice Greene
All providers in Spring Valley, MN · Skilled Nursing Facility in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.