Deloughery Home Limited Partnership

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

328692 Issued in MN

Legal business name

DELOUGHERY HOME LIMITED PARTNERSHIP

Doing business as

Lewiston Villa Nursing Home

Practice address

505 E Main St
Lewiston, MN 55952-1204

Phone

(507) 523-2123

Fax

(507) 523-3699

NPI assigned

Jun 13, 2005

Last updated

Aug 22, 2020By 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

Bob Liebig

Title

Partner

Phone

(651) 483-2586

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Lewiston Villa Nursing Home Doing business as

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265436653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 E MAIN ST",
            "city": "LEWISTON",
            "state": "MN",
            "postal_code": "559521204",
            "telephone_number": "507-523-2123",
            "fax_number": "507-523-3699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 E MAIN ST",
            "city": "LEWISTON",
            "state": "MN",
            "postal_code": "559521204",
            "telephone_number": "507-523-2123",
            "fax_number": "507-523-3699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELOUGHERY HOME LIMITED PARTNERSHIP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LIEBIG",
        "authorized_official_first_name": "BOB",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "651-483-2586"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MN",
            "license": "328692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MN",
            "identifier": "9138LE",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lewiston Villa Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• City of Lewiston
• Carrie Lee Elliott-Plank, RN
• Michael Thomas Flynn, D.D.S.
• Mickel Frisch
• Lewiston Dental Care
• Modern Dental Professionals, MN PC (Midwest Dental)

• Skilled Nursing Facility in Lewiston, MN
• Providers in Lewiston, 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 Aug 22, 2020; 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.