Minnesota Community Hospice Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

CLASS F HOME CARE PR Issued in MN

Legal business name

MINNESOTA COMMUNITY HOSPICE INC

Doing business as

The Lodge on Summit Oaks

Practice address

1412 Summit Oaks Dr
Burnsville, MN 55337-4744

Phone

(952) 431-9120

Fax

(952) 431-9123

NPI assigned

Dec 18, 2007

Last updated

Jan 26, 2015By the provider in NPPES

Organization subpart

Yes

Parent organization

MINNESOTA COMMUNITY HOSPICE INCAs reported in NPPES

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

Authorized official

Name

Gerald John McGowan

Title

Cfo

Phone

(651) 319-1295

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Lodge on Summit Oaks Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Minnesota Community Hospice Inc2 organizations share this tax ID, including this one

Part of

Minnesota Community Hospice Inc

Other organizations with this tax ID 1

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

• Minnesota Community Hospice

  dba the lodge on highview

  • Assisted Living Facility
  • Lakeville, MN
  • NPI 1184923286
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Minnesota Community Hospice

  dba the lodge on highview

  • Assisted Living Facility
  • Lakeville, MN
  • NPI 1184923286
  NPPES parent name

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

{
    "created_epoch": "1197936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422230400000",
    "number": "1275717936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 SUMMIT OAKS DR",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553374744",
            "telephone_number": "952-431-9120",
            "fax_number": "952-431-9123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 SUMMIT OAKS DR",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553374744",
            "telephone_number": "952-431-9120",
            "fax_number": "952-431-9123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINNESOTA COMMUNITY HOSPICE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MINNESOTA COMMUNITY HOSPICE INC",
        "enumeration_date": "2007-12-18",
        "last_updated": "2015-01-26",
        "status": "A",
        "authorized_official_last_name": "MCGOWAN",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "651-319-1295"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MN",
            "license": "CLASS F HOME CARE PR",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "789488000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Lodge on Summit Oaks",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Burnsville, MN
• Providers in Burnsville, MN by specialty
• Assisted Living Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.