Foundation for Rural Health Care

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

00110 Issued in MN

Legal business name

FOUNDATION FOR RURAL HEALTH CARE

Doing business as

Crestview Manor

Practice address

649 State St NW
Evansville, MN 56326-8124

Phone

(218) 948-2219

Fax

(218) 948-2004

NPI assigned

Sep 27, 2005

Last updated

Aug 22, 2020By 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

Coral Blaze, RN,C RAC-C

Title

Ceo/Cfo

Phone

(952) 435-7371

Specialties & licenses 1

Addresses

Other names 1

• Crestview Manor Doing business as

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487640132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 W 155TH ST",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553065405",
            "telephone_number": "952-435-7371",
            "fax_number": "952-892-1695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "649 STATE ST NW",
            "city": "EVANSVILLE",
            "state": "MN",
            "postal_code": "563268124",
            "telephone_number": "218-948-2219",
            "fax_number": "218-948-2004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNDATION FOR RURAL HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BLAZE",
        "authorized_official_first_name": "CORAL",
        "authorized_official_title_or_position": "CEO/CFO",
        "authorized_official_telephone_number": "952-435-7371",
        "authorized_official_credential": "RN,C RAC-C"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MN",
            "license": "00110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crestview Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dee Ann Baune
• Evansville Care Campus LLC (Evansville Care Center)
• Evansville Care Campus LLC (Evansville Senior Living)
• Foundation for Rural Health Care (Evansville Residence)
• Kramer Chiropractic P.a.
• Donna K Meissner
• Philicity Kae Messman, LICSW
• Carlie Jo Steffenson
• Arla May Trampusch, MOTR/L

• Skilled Nursing Facility in Evansville, MN
• Providers in Evansville, 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.