Inter-Faith Care Center

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

328357 Issued in MN

Legal business name

INTER-FAITH CARE CENTER

Doing business as

Carlton Place

Practice address

813 3Rd St
Carlton, MN 55718-9201

Phone

(218) 384-8440

Fax

(218) 384-8442

NPI assigned

Dec 23, 2005

Last updated

Jul 9, 2008By 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. Larry C Penk, ADMINISTRATOR

Title

Admin

Phone

(218) 384-8411

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Carlton Place Doing business as

Tax ID family

Carlton Place2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Inter-Faith Care Center

  • Skilled Nursing Facility
  • Carlton, MN
  • NPI 1134125644
  NPD tax ID

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

{
    "created_epoch": "1135296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215561600000",
    "number": "1629055231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 3RD ST",
            "city": "CARLTON",
            "state": "MN",
            "postal_code": "557189201",
            "telephone_number": "218-384-8440",
            "fax_number": "218-384-8442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 3RD ST",
            "city": "CARLTON",
            "state": "MN",
            "postal_code": "557189201",
            "telephone_number": "218-384-8440",
            "fax_number": "218-384-8442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTER-FAITH CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-23",
        "last_updated": "2008-07-09",
        "status": "A",
        "authorized_official_last_name": "PENK",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "ADMIN",
        "authorized_official_telephone_number": "218-384-8411",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ADMINISTRATOR"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MN",
            "license": "328357",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "090963700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carlton Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Megan Lee Bodin
• Leeann Christiansen, RDH
• City of Carlton (Carlton Ambulance Service)
• Community Addiction Recovery Enterprise Carlton (CARE Carlton)
• Inter-Faith Care Center
• Kristen Marie Jaster, APRN, CNP
• Kirsten K Komarek, RDH
• Steven Boyd Kottke, DDS
• Kimberly Kroll, OTR
• Lake Superior Community Health Center

• Assisted Living Facility in Carlton, MN
• Providers in Carlton, 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 Jul 9, 2008; 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.