NPIMap

Organization Active NPI

Sisters of Mary of the Presentation Long Term Care

Doing business as Maryhill Manor

  • Skilled Nursing Facility
  • Enderlin, ND
National Provider Identifier
1295730653
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
1074A Issued in ND
Legal business name
SISTERS OF MARY OF THE PRESENTATION LONG TERM CARE
Doing business as
Maryhill Manor
Practice address
110 Hillcrest Dr
Enderlin, ND 58027-1129
Phone
(701) 437-3544
Fax
(701) 437-3816
NPI assigned
Jun 14, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Nancy Farnham
Title
Ceo
Phone
(701) 437-3544

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 1074A ND Primary

Addresses

Primary practice location

110 Hillcrest Dr
Enderlin, ND 58027-1129

Mailing address

110 Hillcrest Dr
Enderlin, ND 58027-1129
Phone (701) 437-3544

Other identifiers 2

IdentifierTypeStateIssuer
12468OtherNDND BLUE CROSS
30421MedicaidND

Other names 1

  • Maryhill Manor Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030520000043 ND Part A Provider - Skilled Nursing Facility 8921917766 Practice locations: Enderlin, ND

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1295730653. Details of each certification follow.

Skilled nursing facility certification: CCN 355108

Legal name
SISTERS OF MARY OF THE PRESENTATION LONG TERM CARE
Doing business as
SMP HEALTH - MARYHILL
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Sep 1, 1991
Last certification
Sep 12, 2024
Beds
42
Ownership / control type
Nonprofit Corporation
Multi-facility organization
Sisters of Mary of The Presentation
Organization structure
CorporationNon-profit
Incorporated
Apr 1, 2002 in ND
Enrollment address
110 Hillcrest Dr
Enderlin, ND 58027-1129
Nursing home name
SMP HEALTH - MARYHILL
Affiliated entity
SMP HEALTH

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
SMP Health - MaryhillCCN 355108 · All quality measures
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
5 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Sep 1, 1991
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
4241.0 residents per day on average
Chain
SMP Health5 facilities in the chain
Penalties (3 years)
1Fines totaling $10,036

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
35D0686638SMP Health - Maryhill110 Hillcrest Dr, Enderlin, ND 58027Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Villa Maria9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Ownership & related parties

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
David M Montecuollo Individual Corporate Director Jul 1, 2018
Frank E Redlin Individual Corporate Director Jul 1, 2018
Lynette C Schmitz Individual Corporate Director Jul 1, 2016
Bailyn Walz Individual W-2 Managing EmployeeChief Executive Officer Oct 1, 2021 100%
Operational/Managerial ControlChief Executive Officer Oct 1, 2021 100%
Aaron K Alton Individual Corporate OfficerPresident/Ceo Apr 1, 2002 100%
Operational/Managerial Control Apr 1, 2002
Sharon Houle Individual Corporate Director Feb 6, 2020
Becky Hansen Individual Corporate OfficerVice President of Finance Oct 1, 2020 100%
Corporate Director Jul 1, 2021
Paul J Carson Individual Corporate Director Dec 1, 2020
Sisters of Mary of the Presentation Long Term Care Organization, Enderlin, ND Non-profit Operational/Managerial Control Apr 1, 2002 100%

Owners & managing parties with NPI records 5

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
SMP Health - Ave MariaJamestown, ND, CCN 355082 Skilled nursing facility Operational/Managerial Control (100%) Apr 1, 2002

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

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.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1118707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295730653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 HILLCREST DR",
            "city": "ENDERLIN",
            "state": "ND",
            "postal_code": "580271129",
            "telephone_number": "701-437-3544",
            "fax_number": "701-437-3816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 HILLCREST DR",
            "city": "ENDERLIN",
            "state": "ND",
            "postal_code": "580271129",
            "telephone_number": "701-437-3544",
            "fax_number": "701-437-3816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SISTERS OF MARY OF THE PRESENTATION LONG TERM CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FARNHAM",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "701-437-3544"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "ND",
            "license": "1074A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ND BLUE CROSS",
            "identifier": "12468",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30421",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maryhill Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Enderlin, ND

Sources for this page

Verify at the official NPI Registry.