Wood Dale Home Operating LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

WOOD DALE HOME OPERATING LLC

Practice address

600 Sunrise Blvd
Redwood Falls, MN 56283-1863

Phone

(507) 637-3587

NPI assigned

May 1, 2020

Organization subpart

No

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

Authorized official

Name

Josh Legum

Title

Ceo

Phone

(507) 203-1001

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1588291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615161600000",
    "number": "1326669227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "638 SOUTHBEND AVE",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560012168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 SUNRISE BLVD",
            "city": "REDWOOD FALLS",
            "state": "MN",
            "postal_code": "562831863",
            "telephone_number": "507-637-3587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOOD DALE HOME OPERATING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-01",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A",
        "authorized_official_last_name": "LEGUM",
        "authorized_official_first_name": "JOSH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "507-203-1001"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tabitha Towery
• Walmart Inc. (Walmart Pharmacy 10-1865)
• Georgianna Helen Whiteley, MD
• Anglea Marie Wilson, OTR/L
• Wood Dale Home Inc

• Skilled Nursing Facility in Redwood Falls, MN
• Providers in Redwood Falls, 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 Mar 8, 2021; 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.