Elders Home Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

329990 Issued in MN

Legal business name

ELDERS HOME INC

Practice address

215 S Tousley Ave
New York Mills, MN 56567

Phone

(218) 385-2005

Fax

(218) 385-4170

NPI assigned

Jan 20, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Calvin Bruce Anderson, LNHA

Title

Administrator

Phone

(218) 385-2005

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356321624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 188",
            "city": "NEW YORK MILLS",
            "state": "MN",
            "postal_code": "56567",
            "telephone_number": "218-385-2005",
            "fax_number": "218-385-4170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 S TOUSLEY AVE",
            "city": "NEW YORK MILLS",
            "state": "MN",
            "postal_code": "56567",
            "telephone_number": "218-385-2005",
            "fax_number": "218-385-4170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELDERS HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "CALVIN",
        "authorized_official_middle_name": "BRUCE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "218-385-2005",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MN",
            "license": "329990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "7100439",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8774EL",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allen Bruce Alvig, L.A.D.C.
• Connie Lynn Bien
• Tracy Brown, PSY.S., NCSP
• Rachel Krekula Grieger, DDS
• Bobbi Jo M. Hamilton
• Tammie Hamlin, RN
• Gregory B Hammers, DDS
• Independent School District 553

• Skilled Nursing Facility in New York Mills, MN
• Providers in New York Mills, 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 Aug 22, 2020; 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.