Talahi Nursing & Rehab Center LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

TALAHI NURSING & REHAB CENTER LLC

Doing business as

Talahi Senior Campus

Practice address

1717 University Dr SE
Saint Cloud, MN 56304-2023

Phone

(320) 251-9120

NPI assigned

Jun 11, 2013

Last updated

Sep 16, 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

Mr. Max Stesel

Title

Member

Phone

(773) 825-3336

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Talahi Senior Campus Doing business as

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1558709683. Details of each certification follow.

• CCN 245438 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 245438

Legal name

TALAHI NURSING & REHAB CENTER LLC

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Feb 1, 1987

Last certification

May 15, 2024

Beds

77

Ownership / control type

Limited Liability Corporation

Multi-facility organization

614

Organization structure

LLCProprietary

Incorporated

Jan 22, 2013 in MN

Enrollment address

1717 University Dr SE
St Cloud, MN 56304-2023

Nursing home name

EDENBROOK OF ST CLOUD

Affiliated entity

EDEN SENIOR CARE

Listed as

Edenbrook of St CloudCCN 245438 · All quality measures

Overall star rating

3 of 5

Health inspections

3 of 5

Staffing

4 of 5

Quality measures

3 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Feb 1, 1987

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

7766.8 residents per day on average

Chain

Eden Senior Care21 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Cynthia A Carlson, MD

  • Family Medicine Physician
  • Minneapolis, MN
  • NPI 1427035401
  NPD (past)
• Kelsi K. Nelson, M.D.

  • Family Medicine Physician
  • Minneapolis, MN
  • NPI 1992733976
  NPD (past)
• Mylin Concepcion West, M.D.

  • Family Medicine Physician
  • Coon Rapids, MN
  • NPI 1659472280
  NPD (past)

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Cynthia A Carlson, MD

  • Family Medicine Physician
  • Minneapolis, MN
  • NPI 1427035401

  Nursing home

  Care Compare affiliation
• Tamara Lois Rakke, AGPCNP

  • Adult Health Nurse Practitioner
  • Stillwater, MN
  • NPI 1932655420

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1370908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600214400000",
    "number": "1558709683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 MCCORMICK BLVD",
            "address_2": "STE 112",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600762961",
            "telephone_number": "773-825-3336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 UNIVERSITY DR SE",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563042023",
            "telephone_number": "320-251-9120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TALAHI NURSING & REHAB CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-11",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A",
        "authorized_official_last_name": "STESEL",
        "authorized_official_first_name": "MAX",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "773-825-3336",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "885463000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Talahi Senior Campus",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Talahi Senior Campus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rukayat Mayowa Taiwo, MD
• Aden Takal
• Hawa Takal
• Khadro Takal
• Talahi Home Health, LLC
• Erin Talberg, MSW, LICSW
• Michael C Tan, M.D.
• Craig Tangen
• Vivian Ruby Tangen
• Tanzil Transportation LLC

• Skilled Nursing Facility in Saint Cloud, MN
• Providers in Saint Cloud, 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 Sep 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.