Vop South Grove Lodge, LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

VOP SOUTH GROVE LODGE, LLC

Doing business as

South Grove Lodge Senior Living

Practice address

1701 22ND Ave SW
Austin, MN 55912-1798

Phone

(507) 396-4960

Fax

(507) 434-0041

NPI assigned

Dec 8, 2021

Organization subpart

No

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

Authorized official

Name

Ms. Terri Lynn Baker

Title

Director of Licensing

Phone

(503) 998-5810

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• South Grove Lodge Senior Living Doing business as

Electronic endpoints 1

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

CLIA laboratory certificates

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

{
    "created_epoch": "1638921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775001600000",
    "number": "1295494110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5101 NE 82ND AVE STE 200",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626343",
            "telephone_number": "503-998-5810",
            "fax_number": "360-254-1770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 22ND AVE SW",
            "city": "AUSTIN",
            "state": "MN",
            "postal_code": "559121798",
            "telephone_number": "507-396-4960",
            "fax_number": "507-434-0041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VOP SOUTH GROVE LODGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-08",
        "last_updated": "2026-04-01",
        "certification_date": "2026-04-01",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "TERRI",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "DIRECTOR OF LICENSING",
        "authorized_official_telephone_number": "503-998-5810",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MINNESOTA DEPARTMENT OF HEALTH (MDH) - ELDERLY WAIVER",
            "identifier": "404147",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Austin",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1701 22nd Ave SW",
            "city": "Austin",
            "state": "MN",
            "country_code": "US",
            "postal_code": "559121798",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "South Grove Lodge Senior Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Adult Care Home Facility in Austin, MN
• Providers in Austin, MN by specialty
• Adult Care Home Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2026; 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.