NPIMap

Organization Active NPI

Bridgewell

Doing business as Galeon

  • Assisted Living Facility
  • Osakis, MN
National Provider Identifier
1205099231
Registry record updated Nov 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
339876 Issued in MN
Legal business name
BRIDGEWELL
Doing business as
Galeon
Practice address
410 W Main St
Osakis, MN 56360-8243
Phone
(320) 859-2142
Fax
(320) 859-6292
NPI assigned
Jul 9, 2008
Last updated
Nov 28, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMUNITY MEMORIAL HOME AT OSAKIS MINNESOTA INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 28, 2011

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

Authorized official

Name
Dave Bruce Carlson
Title
Administrator
Phone
(320) 859-2142

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 339876 MN Primary

Addresses

Primary practice location

410 W Main St
Osakis, MN 56360-8243

Mailing address

410 W Main St
Osakis, MN 56360-8243
Phone (320) 859-2142

Other names 1

  • Galeon Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Community Memorial Home at Osakis Minn Incorporated4 organizations share this tax ID, including this one
Part of
Community Memorial Home at Osakis Minn Incorporated

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1215561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322438400000",
    "number": "1205099231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 W MAIN ST",
            "city": "OSAKIS",
            "state": "MN",
            "postal_code": "563608243",
            "telephone_number": "320-859-2142",
            "fax_number": "320-859-6292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 W MAIN ST",
            "city": "OSAKIS",
            "state": "MN",
            "postal_code": "563608243",
            "telephone_number": "320-859-2142",
            "fax_number": "320-859-6292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGEWELL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY MEMORIAL HOME AT OSAKIS MINNESOTA INC",
        "enumeration_date": "2008-07-09",
        "last_updated": "2011-11-28",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "DAVE",
        "authorized_official_middle_name": "BRUCE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "320-859-2142"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MN",
            "license": "339876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Galeon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Osakis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2011; 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.