Shepherd's Home LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SHEPHERD'S HOME LLC

Doing business as

Mangers Way Home

Practice address

10652 Alison Way
Inver Grove Heights, MN 55077-5472

Phone

(612) 308-1220

Fax

(612) 500-4723

NPI assigned

Jun 21, 2023

Last updated

Jun 21, 2023By 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

Elibelle Jardio, RNNPI 1346884970

Title

Member

Phone

(612) 308-1220

Specialties & licenses 1

Addresses

Other names 1

• Mangers Way Home 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

Mangers Way Home2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Shepherd's Home LLC

  dba Shepherd's Way Home

  • Assisted Living Facility
  • Woodbury, MN
  • NPI 1760191001
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Elibelle R Jardio, BSN

  • Registered Nurse
  • Stillwater, MN
  • NPI 1346884970
  NPD Authorized official

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

{
    "created_epoch": "1687305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687305600000",
    "number": "1295410660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8381 YEARLING DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551297600",
            "telephone_number": "612-308-1220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10652 ALISON WAY",
            "city": "INVER GROVE HEIGHTS",
            "state": "MN",
            "postal_code": "550775472",
            "telephone_number": "612-308-1220",
            "fax_number": "612-500-4723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHEPHERD'S HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-21",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A",
        "authorized_official_last_name": "JARDIO",
        "authorized_official_first_name": "ELIBELLE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "612-308-1220",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mangers Way Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Andrew Louis Seliga, PA-C
• Taryn Renee Sellers, LICSW
• Samuel P Seltz, MD
• Maxwell Richard Seppelt
• Amy Youan Shantz, PT, DPT
• Sheriffs Youth Programs of Minnesota
• Anna Shukla, NP-C
• Daisy Silva Villeda
• Geza Simon, MD
• Amanda Marie Simone-Belin, M.D.

• Assisted Living Facility in Inver Grove Heights, MN
• Providers in Inver Grove Heights, 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 Jun 21, 2023; 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.