Kelliher Care Center Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

337372 Issued in MN

Legal business name

KELLIHER CARE CENTER INC

Doing business as

Cornerstone Residence of Kelliher

Practice address

280 Main Street West
Kelliher, MN 56650

Phone

(218) 647-8258

Fax

(218) 647-8483

NPI assigned

Oct 2, 2007

Last updated

Oct 2, 2007By 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. Allen Potvin

Title

President

Phone

(218) 435-6205

Specialties & licenses 1

Addresses

Other names 1

• CORNERSTONE RESIDENCE OF KELLIHER 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

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

{
    "created_epoch": "1191283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191283200000",
    "number": "1457548661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 MAIN STREET WEST",
            "address_2": "PO BOX 189",
            "city": "KELLIHER",
            "state": "MN",
            "postal_code": "56650",
            "telephone_number": "218-647-8258",
            "fax_number": "218-647-8483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 MAIN STREET WEST",
            "city": "KELLIHER",
            "state": "MN",
            "postal_code": "56650",
            "telephone_number": "218-647-8258",
            "fax_number": "218-647-8483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLIHER CARE CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-02",
        "last_updated": "2007-10-02",
        "status": "A",
        "authorized_official_last_name": "POTVIN",
        "authorized_official_first_name": "ALLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "218-435-6205",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MN",
            "license": "337372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CORNERSTONE RESIDENCE OF KELLIHER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kelliher Care Center Inc.
• Kelliher Isd #36
• Sanford Health of Northern Minnesota (Sanford Health Kelliher Clinic)
• Shauntel Zeman, M.S., CCC-SLP

• Assisted Living Facility in Kelliher, MN
• Providers in Kelliher, MN by specialty
• Assisted Living Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2007; 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.