Chisholm Health Center
Organization Active NPI Skilled Nursing Facility · Chisholm, MN
NPI 1508814575 · NPPES record last updated Feb 5, 2025
Key facts
- NPI
- 1508814575
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 328696 (MN)
- Legal business name
- CHISHOLM HEALTH CENTER
- Practice address
- 321 6TH St NE
Chisholm, MN 55719-1287 - Phone
- (218) 254-5765
- Fax
- (218) 254-5767
- NPI assigned
- May 4, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- ST. FRANCIS HEALTH SERVICES OF MORRIS, INC
Authorized official
- Name
- Curtis Bach
- Title
- Cfo
- Phone
- (320) 589-4910
Owners & managing parties with NPI records 3
-
Jeffrey Allan Copeman, M.D.
-
Michael Lair, OD
Facilities with the same owner 18
Practitioners 2
-
Jeffrey Allan Copeman, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 24D0403613 | Heritage Manor Health Care Center | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Skilled nursing facility certification: CCN 245245B
- Legal name
- CHISHOLM HEALTH CENTER
- Doing business as
- HERITAGE MANOR
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jun 30, 1997 in MN
- Enrollment address
- 321 NE 6TH St
Chisholm, MN 55719-1287 - Nursing home name
- HERITAGE MANOR
- Affiliated entity
- ST. FRANCIS HEALTH SERVICES
All disclosed owners & managing parties 42
| Name | Role | Since | Share |
|---|---|---|---|
| Matthew Just |
Operational/Managerial Control | Jan 1, 2025 | |
| Adp of the SNF | Jan 1, 2025 | ||
| Rosanne Blevins |
Operational/Managerial Control | May 18, 2018 | |
| Adp of the SNF | May 18, 2018 | ||
| Reed Hofmann |
Operational/Managerial Control | May 8, 2023 | |
| Adp of the SNF | May 8, 2023 | ||
| Jeffrey Copeman |
Operational/Managerial Control | Jan 1, 2025 | |
| Adp of the SNF | Jan 1, 2025 | ||
| Jennifer Ann Goodnough |
Corporate Director |
Jan 1, 2021 | |
| Operational/Managerial Control | Jan 1, 2021 | ||
| Adp of the SNF | Jan 1, 2021 | ||
| Megan Caspers |
Operational/Managerial Control | Dec 29, 2014 | |
| Adp of the SNF | Dec 29, 2014 | ||
| Cami Cay Peterson-Devries |
Corporate Officer |
May 8, 2022 | |
| Corporate Director |
May 8, 2022 | ||
| Operational/Managerial Control |
May 8, 2022 | ||
| Adp of the SNF | May 8, 2022 | ||
| Big Stone Therapies, Inc |
Operational/Managerial Control | Feb 3, 2015 | |
| Adp of the SNF | Oct 22, 2025 | ||
| Steven Edward Lienemann |
Corporate Director |
Jan 1, 2025 | |
| Operational/Managerial Control | Jan 1, 2025 | ||
| Adp of the SNF | Jan 1, 2025 | ||
| Timothy Chris Gramm |
Corporate Director |
Jan 1, 2023 | |
| Operational/Managerial Control | Jan 1, 2023 | ||
| Adp of the SNF | Jan 1, 2023 | ||
| Amanda Burrows |
Operational/Managerial Control | Jan 2, 2024 | |
| Adp of the SNF | Jan 2, 2024 | ||
| Michael Evalthen Lair |
Corporate Director |
Jan 1, 2025 | |
| Operational/Managerial Control | Jan 1, 2025 | ||
| Adp of the SNF | Jan 1, 2025 | ||
| April Tomoson |
Operational/Managerial Control | Jul 12, 2021 | |
| Adp of the SNF | Jul 12, 2021 | ||
| Douglas William Ehlers |
Corporate Director |
Jan 1, 2023 | |
| Operational/Managerial Control | Jan 1, 2023 | ||
| Adp of the SNF | Jan 1, 2023 | ||
| Amy Walker |
Operational/Managerial Control | May 13, 2024 | |
| Adp of the SNF | May 13, 2024 | ||
| Daniel Lee Dripps |
Corporate Director |
Jan 1, 2016 | |
| Operational/Managerial Control | Jan 1, 2016 | ||
| Adp of the SNF | Jan 1, 2016 | ||
| Paul James Rentz |
Corporate Director |
Jan 1, 2021 | |
| Operational/Managerial Control | Jan 1, 2021 | ||
| Adp of the SNF | Jan 1, 2021 | ||
| Curtis Allan Bach |
Corporate Officer |
Aug 28, 2024 | |
| Corporate Director |
Aug 28, 2024 | ||
| Operational/Managerial Control | Aug 28, 2024 | ||
| Adp of the SNF | Aug 28, 2024 | ||
| Cindy McGraw |
Operational/Managerial Control | Mar 15, 1988 | |
| Adp of the SNF | Mar 15, 1988 | ||
| Geoffrey Ryan |
Operational/Managerial Control | Jan 12, 1998 | |
| Adp of the SNF | Jan 12, 1998 | ||
| Lorraine Ann Wiese |
Corporate Director |
Jul 25, 2017 | |
| Operational/Managerial Control | Jul 25, 2017 | ||
| Adp of the SNF | Jul 25, 2017 | ||
| St. Francis Health Services of Morris, Inc |
5% Or Greater Direct Ownership Interest | May 10, 2002 | 100% |
| Operational/Managerial Control | May 10, 2002 | ||
| Adp of the SNF | Dec 1, 2025 | ||
| Shelley Barnard |
Adp of the SNF | Mar 31, 2025 | |
| Mark James Rentz |
Operational/Managerial Control | Apr 22, 2024 | |
| Adp of the SNF | Apr 22, 2024 | ||
| Glenda Townley |
Operational/Managerial Control | Feb 8, 1999 | |
| Adp of the SNF | Feb 8, 1999 | ||
| Amy Rausch |
Adp of the SNF | Apr 22, 2025 | |
| Shane Roche |
Operational/Managerial Control | May 8, 2017 | |
| Adp of the SNF | May 8, 2017 | ||
| Carol Annette Raw |
Corporate Officer |
Aug 16, 2005 | |
| Corporate Director |
Aug 16, 2005 | ||
| Operational/Managerial Control |
Aug 16, 2005 | ||
| Adp of the SNF | Aug 16, 2005 | ||
| Patrick Gary Nelson |
Corporate Director |
Jan 1, 2020 | |
| Operational/Managerial Control | Jan 1, 2020 | ||
| Adp of the SNF | Jan 1, 2020 | ||
| Michelle Hanneken |
Operational/Managerial Control | Jul 20, 2022 | |
| Adp of the SNF | Jul 20, 2022 | ||
| Roxanne Hejhal |
Operational/Managerial Control | Apr 10, 2023 | |
| Adp of the SNF | Apr 10, 2023 | ||
| Elisabeth Incontro |
Operational/Managerial Control | Apr 17, 2013 | |
| Adp of the SNF | Apr 17, 2013 | ||
| Emily Anderson |
Operational/Managerial Control | Jun 2, 2017 | |
| Adp of the SNF | Jun 2, 2017 | ||
| Jina Marlow |
Operational/Managerial Control | Jun 6, 2022 | |
| Adp of the SNF | Jun 6, 2022 | ||
| Eide Bailly LLP |
Operational/Managerial Control | Jan 3, 2023 | |
| Adp of the SNF | Oct 22, 2025 | ||
| Todd Patrick Schneider |
Corporate Director |
Jul 1, 2013 | |
| Operational/Managerial Control | Jul 1, 2013 | ||
| Adp of the SNF | Jul 1, 2013 | ||
| Renee Thompson |
Operational/Managerial Control | Oct 10, 2018 | |
| Adp of the SNF | Oct 10, 2018 | ||
| Esa Bay |
Operational/Managerial Control | Aug 7, 2025 | |
| Adp of the SNF | Aug 7, 2025 | ||
| John Henry Luetmer |
Corporate Director |
Jan 1, 2021 | |
| Operational/Managerial Control | Jan 1, 2021 | ||
| Adp of the SNF | Jan 1, 2021 | ||
| Laura Jane Rentz |
Corporate Director |
Jan 1, 2024 | |
| Operational/Managerial Control | Jan 1, 2024 | ||
| Adp of the SNF | Jan 1, 2024 | ||
| Ben Ryan |
Operational/Managerial Control | Dec 27, 2012 | |
| Adp of the SNF | Dec 27, 2012 | ||
| Kelsey Stock |
Operational/Managerial Control | Jun 1, 2022 | |
| Adp of the SNF | Jun 1, 2022 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041208000137 | MN | Part a Provider - Skilled Nursing Facility | 6901862226 | Practice locations: Chisholm, MN |
National Provider Directory
- Part of
- St Francis Health Services of Morris Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 328696 | MN | Yes |
Addresses
Primary practice location
321 6TH St NE
Chisholm, MN 55719-1287
Mailing address
801 Nevada Ave
Morris, MN 56267-1865
Phone (320) 589-2004
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NH0563 | Other | UCARE | |
| 7122706 | Other | MEDICA | |
| 936651200 | Medicaid | MN | |
| 9605HE | Other | BCBS | |
| 140017 | Other | FIRST PLAN |
Other names
- Heritage Manor
Other providers in Chisholm, MN
- Casey Drug-a Inc
- Aden Casey
- Alida Erin Casey
- Children'S Dental Services
- Chisholm Dental Service PA
- Chisholm Medical Clinic
- City of Chisholm
- Elizabeth Copeman
- E.H. Lawrence Co., Inc.
- Timothy William Ellison
All providers in Chisholm, MN · Skilled Nursing 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 Feb 5, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.