Organization Active NPI

Koochiching Health Services

Doing business as Littlefork Care Center

  • Skilled Nursing Facility
  • Littlefork, MN
National Provider Identifier
1609233980
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
KOOCHICHING HEALTH SERVICES
Doing business as
Littlefork Care Center
Practice address
912 Main St
Littlefork, MN 56653-9357
Phone
(218) 278-6634
Fax
(218) 278-6637
NPI assigned
Jan 18, 2016
Last updated
Feb 5, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
ST. FRANCIS HEALTH SERVICES OF MORRIS INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Curtis Bach
Title
Cfo
Phone
(320) 589-4910

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

912 Main St
Littlefork, MN 56653-9357

Mailing address

801 Nevada Ave Ste 100
Morris, MN 56267-1874
Phone (320) 589-2004

Other names 1

  • Littlefork Care Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160205001167 MN Part A Provider - Skilled Nursing Facility 8820392277 Practice locations: Littlefork, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1609233980. Details of each certification follow.

Skilled nursing facility certification: CCN 245542

Legal name
KOOCHICHING HEALTH SERVICES
Doing business as
LITTLEFORK CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 24, 1991
Last certification
Feb 27, 2025
Beds
42
Ownership / control type
Nonprofit Corporation
Multi-facility organization
St. Francis Health Services
Organization structure
CorporationNon-profit
Incorporated
Dec 23, 2015 in MN
Enrollment address
912 Main St
Littlefork, MN 56653-9378
Nursing home name
LITTLEFORK CARE CENTER
Affiliated entity
ST. FRANCIS HEALTH SERVICES

Care Compare: Nursing home

Medicare Care Compare
Listed as
Littlefork Care CenterCCN 245542 · All quality measures
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
4 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Apr 24, 1991
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
4236.3 residents per day on average
Chain
St. Francis Health Services14 facilities in the chain
Penalties (3 years)
2Fines totaling $218,595

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D2111016Littlefork Care Center912 Main Street, Littlefork, MN 56653Certificate of waiverMar 28, 2028

National Provider Directory

National Provider Directory
Tax ID family
Jack Pine Chateau3 organizations share this tax ID, including this one
Part of
St Francis Health Services of Morris Inc

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 39

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

NameRoleSinceShare
Reed Hofmann Individual Operational/Managerial Control May 8, 2023
Adp of the SNF May 8, 2023
Jeffrey Copeman Individual Operational/Managerial Control Jan 1, 2025
Adp of the SNF Jan 1, 2025
Jennifer Ann Goodnough Individual Corporate DirectorGovernance Board Chair Jan 1, 2021
Operational/Managerial Control Jan 1, 2021
Managing Control - Governing BodyGovernance Board Chair Jan 1, 2021
Adp of the SNF Jan 1, 2021
Erin Nash Individual Operational/Managerial Control Jul 28, 2025
Adp of the SNF Jul 28, 2025
Megan Caspers Individual Operational/Managerial Control Dec 29, 2014
Adp of the SNF Dec 29, 2014
Cami Cay Peterson-Devries Individual Corporate OfficerVP of Senior Services/SNF President May 8, 2022
Corporate DirectorVP of Senior Services/SNF President May 8, 2022
Operational/Managerial Control May 8, 2022
Adp of the SNF May 8, 2022
Steven Edward Lienemann Individual Corporate DirectorGovernance Board Director Dec 31, 2011
Operational/Managerial Control Jan 1, 2025
Managing Control - Governing BodyGovernance Board Director Jan 1, 2025
Adp of the SNF Jan 1, 2025
Timothy Chris Gramm Individual Corporate DirectorGovernance Board Director Jan 1, 2023
Operational/Managerial Control Jan 1, 2023
Managing Control - Governing BodyBoard Director Jan 1, 2023
Amanda Burrows Individual Operational/Managerial Control Jan 2, 2024
Adp of the SNF Jan 2, 2024
Michael Evalthen Lair Individual Corporate DirectorGovernance Board Director Jan 1, 2025
Operational/Managerial Control Jan 1, 2025
Managing Control - Governing BodyGovernance Board Director Jan 1, 2025
Adp of the SNF Jan 1, 2025
Cindy Tomczak Individual Adp of the SNF Jun 15, 2023
International Falls Memorial Hospital Association Organization, International Falls, MN Corporation, Medical provider/supplier Operational/Managerial Control Apr 1, 2016
Adp of the SNF Oct 23, 2025
Wanda Grashorn Individual Operational/Managerial Control Jan 1, 2024
Adp of the SNF Jan 1, 2024
April Tomoson Individual Operational/Managerial Control Jul 12, 2021
Adp of the SNF Jul 12, 2021
Douglas William Ehlers Individual Corporate DirectorGovernance Board Director Jan 1, 2023
Operational/Managerial Control Jan 1, 2023
Managing Control - Governing BodyGovernance Board Director Jan 1, 2023
Adp of the SNF Jan 1, 2023
Amy Walker Individual Operational/Managerial Control May 13, 2024
Adp of the SNF May 13, 2024
Daniel Lee Dripps Individual Corporate DirectorGovernance Board Director Jan 1, 2016
Operational/Managerial Control Jan 1, 2016
Managing Control - Governing BodyGovernance Board Director Jan 1, 2016
Adp of the SNF Jan 1, 2016
Curtis Allan Bach Individual Corporate OfficerVP of Finance/Cfo Aug 28, 2024
Corporate Director Aug 28, 2024
Operational/Managerial Control Aug 28, 2024
Adp of the SNF Aug 28, 2024
Geoffrey Ryan Individual Operational/Managerial Control Jan 12, 1998
Adp of the SNF Jan 12, 1998
Lorraine Ann Wiese Individual Corporate DirectorGovernance Board Sec/Treas Jul 25, 2017
Operational/Managerial Control Jul 25, 2017
Managing Control - Governing BodyGovernance Board Sec/Treas Jul 25, 2017
Adp of the SNF Jul 25, 2017
St. Francis Health Services of Morris, Inc Organization, Morris, MN Corporation, Non-profit, Chain home office 5% Or Greater Direct Ownership Interest Apr 1, 2016 100%
Operational/Managerial Control Apr 1, 2016 100%
Adp of the SNF Dec 1, 2025
Cindy Hohenstein Individual Operational/Managerial Control Apr 30, 2025
Adp of the SNF Apr 30, 2025
Mark James Rentz Individual Operational/Managerial Control Apr 22, 2024
Adp of the SNF Apr 22, 2024
Cathy Nuthak Individual Operational/Managerial Control Sep 18, 2009
Adp of the SNF Sep 18, 2009
Carol Annette Raw Individual Corporate OfficerChief Executive Officer Aug 16, 2005
Corporate DirectorChief Executive Officer Aug 16, 2005
Operational/Managerial Control Aug 16, 2005
Adp of the SNF Aug 16, 2005
Patrick Gary Nelson Individual Corporate DirectorGovernance Board Vice Chair Jan 1, 2020
Operational/Managerial Control Jan 1, 2020
Managing Control - Governing BodyGovernance Board Director Jan 1, 2020
Adp of the SNF Jan 1, 2020
Michelle Hanneken Individual Operational/Managerial Control Jul 20, 2022
Adp of the SNF Jul 20, 2022
Tami Hell Individual Operational/Managerial Control Oct 9, 2025
Adp of the SNF Oct 9, 2025
Roxanne Hejhal Individual Operational/Managerial Control Apr 10, 2023
Adp of the SNF Apr 10, 2023
Jina Marlow Individual Operational/Managerial Control Jun 6, 2022
Adp of the SNF Jun 6, 2022
Eide Bailly LLP Organization, Fargo, ND LLC Operational/Managerial Control Jan 3, 2023
Adp of the SNF Oct 23, 2025
William Fairchild Individual Operational/Managerial Control Aug 7, 2006
Adp of the SNF Aug 7, 2006
Todd Patrick Schneider Individual Corporate DirectorGovernance Board Director Jul 1, 2013
Operational/Managerial Control Jul 1, 2013
Managing Control - Governing BodyGovernance Board Director Jul 1, 2013
Adp of the SNF Jul 1, 2013
Renee Thompson Individual Operational/Managerial Control Oct 10, 2018
Adp of the SNF Oct 10, 2018
John Henry Luetmer Individual Corporate DirectorGovernance Board Director Jan 1, 2021
Operational/Managerial Control May 14, 1957
Managing Control - Governing BodyGovernance Board Director Jan 1, 2021
Adp of the SNF Jan 1, 2021
Laura Jane Rentz Individual Corporate DirectorGovernance Board Director Jan 1, 2024
Operational/Managerial Control Jan 1, 2024
Managing Control - Governing BodyGovernance Board Director Jan 1, 2024
Adp of the SNF Jan 1, 2024
Ben Ryan Individual Operational/Managerial Control Dec 27, 2012
Adp of the SNF Dec 27, 2012
Rebecca McCleery Individual Operational/Managerial Control Jan 1, 2025
Adp of the SNF Jan 1, 2025
Kelsey Stock Individual Operational/Managerial Control Jun 1, 2022
Adp of the SNF Jun 1, 2022

Owners & managing parties with NPI records 6

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 19

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 19

Practitioners & affiliated clinicians

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.

Affiliated clinicians 2

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

NPI Registry JSON

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

{
    "created_epoch": "1453075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738713600000",
    "number": "1609233980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 NEVADA AVE STE 100",
            "city": "MORRIS",
            "state": "MN",
            "postal_code": "562671874",
            "telephone_number": "320-589-2004",
            "fax_number": "320-589-2543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 MAIN ST",
            "city": "LITTLEFORK",
            "state": "MN",
            "postal_code": "566539357",
            "telephone_number": "218-278-6634",
            "fax_number": "218-278-6637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOOCHICHING HEALTH SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. FRANCIS HEALTH SERVICES OF MORRIS INC",
        "enumeration_date": "2016-01-18",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A",
        "authorized_official_last_name": "BACH",
        "authorized_official_first_name": "CURTIS",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "320-589-4910"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Littlefork Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Littlefork, MN

Sources for this page

Verify at the official NPI Registry.