Range Development Company

Primary specialty

Alzheimer Center (Dementia Center)Taxonomy code 311500000X

License

1022171-1AFC Issued in MN

Legal business name

RANGE DEVELOPMENT COMPANY

Doing business as

Chestnut Grove

Practice address

1204 Chestnut St W
Virginia, MN 55792-3445

Phone

(218) 749-6846

Fax

(218) 749-6846

NPI assigned

May 19, 2009

Last updated

May 20, 2009By 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

Mr. Randy P. Schroetter

Title

Executive Director

Phone

(218) 263-4157

Specialties & licenses 4

Addresses

Other names 1

• Chestnut Grove 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

Chestnut Grove2 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.

• Range Development Company

  dba Hillcrest

  • Assisted Living Facility
  • Hibbing, MN
  • NPI 1770718926
  NPD tax ID

Locations

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

{
    "created_epoch": "1242691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242777600000",
    "number": "1386879476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2229 3RD AVE. E",
            "address_2": "P.O. BOX 786",
            "city": "HIBBING",
            "state": "MN",
            "postal_code": "557463445",
            "telephone_number": "218-263-4157",
            "fax_number": "218-263-8534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 CHESTNUT ST W",
            "city": "VIRGINIA",
            "state": "MN",
            "postal_code": "557923445",
            "telephone_number": "218-749-6846",
            "fax_number": "218-749-6846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANGE DEVELOPMENT COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-19",
        "last_updated": "2009-05-20",
        "status": "A",
        "authorized_official_last_name": "SCHROETTER",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "218-263-4157",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "MN",
            "license": "1022171-1AFC",
            "primary": true
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "MN",
            "license": "1022172-1AFC",
            "primary": false
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "MN",
            "license": "1010513-1AFC",
            "primary": false
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "MN",
            "license": "1010514-1AFC",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chestnut Grove",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tess Prochazka
• Deanna Prokosch
• Jordan Przybylski
• Rachelle Jean Pucelj, APRN, CNP
• Quad Cities Therapy Center, LLC
• Range Family Dental LLC
• Range Foot & Ankle, PLC
• Range Medical Services
• Range Mental Health Center
• Range Mental Health Center Inc (Range Treatment Center)

• Alzheimer Center (Dementia Center) in Virginia, MN
• Providers in Virginia, MN by specialty
• Alzheimer Center (Dementia Center) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2009; 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.