Nu Horizons of Southern MN LLC
Organization Active NPI Adult Care Home Facility · Elysian, MN
NPI 1417623596 · NPPES record last updated Aug 19, 2021
Key facts
- NPI
- 1417623596
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Adult Care Home Facility 311ZA0620X
- Legal business name
- NU HORIZONS OF SOUTHERN MN LLC
- Practice address
- 107 Park Ave NE
Elysian, MN 56028-2041 - Phone
- (612) 386-8743
- NPI assigned
- Aug 19, 2021
- Organization subpart
- No
Authorized official
- Name
- Christopher Thomas Johnson
- Title
- Executive Director
- Phone
- (612) 386-8743
Corporate family (same tax ID) 1
National Provider Directory
- Tax ID family
- Nu Horizons of Southern MN LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Care Home Facility | 311ZA0620X | Yes |
Addresses
Primary practice location
107 Park Ave NE
Elysian, MN 56028-2041
Mailing address
PO Box 247
Elysian, MN 56028-0247
Phone (612) 386-8743
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A851678300 | Medicaid | MN | |
| M296987300 | Medicaid | MN | |
| A016698200 | Medicaid | MN | |
| A104640100 | Medicaid | MN | |
| A193658000 | Medicaid | MN | |
| A847930100 | Medicaid | MN | |
| A399148000 | Medicaid | MN | |
| A722960500 | Medicaid | MN | |
| A421408000 | Medicaid | MN | |
| A497458400 | Medicaid | MN | |
| A808132000 | Medicaid | MN |
Other providers in Elysian, MN
All providers in Elysian, MN · Adult Care Home Facility in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 19, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.