Halstad Living Center

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

328227 Issued in MN

Legal business name

HALSTAD LIVING CENTER

Doing business as

Halstad Living Center

Practice address

133 4TH Ave E
Halstad, MN 56548-4114

Phone

(218) 456-2105

Fax

(218) 456-2290

NPI assigned

Oct 11, 2005

Last updated

Mar 22, 2012By the provider in NPPES

Organization subpart

Yes

Parent organization

LUTHERAN HOMESAs reported in NPPES

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

Authorized official

Name

Mr. Dwight A Fuglie, LICENSED ADM.

Title

Executive Director

Phone

(218) 456-2105

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• Halstad Living Center 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 1629066824. Details of each certification follow.

• CCN 245569 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 245569

Legal name

HALSTAD LIVING CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jul 1, 1991

Last certification

Jun 4, 2025

Beds

44

Ownership / control type

Other Nonprofit

Organization structure

CorporationNon-profit

Incorporated

Apr 14, 1969 in MN

Enrollment address

133 4TH Ave E
Halstad, MN 56548-4114

Nursing home name

HALSTAD LIVING CENTER

Listed as

Halstad Living CenterCCN 245569 · All quality measures

Overall star rating

4 of 5

Health inspections

4 of 5

Staffing

4 of 5

Quality measures

3 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Other

Certified

Jul 1, 1991

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

4443.9 residents per day on average

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

Part of

Lutheran Homes

Locations

All disclosed owners & managing parties 9

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

Practitioners 1

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.

• Charles J Breen, MD

  • Family Medicine Physician
  • Hillsboro, ND
  • NPI 1114944113
  NPD (past)

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332374400000",
    "number": "1629066824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 4TH AVE E",
            "city": "HALSTAD",
            "state": "MN",
            "postal_code": "565484114",
            "telephone_number": "218-456-2105",
            "fax_number": "218-456-2290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 4TH AVE E",
            "city": "HALSTAD",
            "state": "MN",
            "postal_code": "565484114",
            "telephone_number": "218-456-2105",
            "fax_number": "218-456-2290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HALSTAD LIVING CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LUTHERAN HOMES",
        "enumeration_date": "2005-10-11",
        "last_updated": "2012-03-22",
        "status": "A",
        "authorized_official_last_name": "FUGLIE",
        "authorized_official_first_name": "DWIGHT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "218-456-2105",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LICENSED ADM."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MN",
            "license": "328227",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ND BLUE CROSS AND BLUE SH",
            "identifier": "23605",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30280",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "075740300",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN BC-BS",
            "identifier": "9506 HA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA INSURANCVE",
            "identifier": "7122758",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Halstad Living Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joyce Claire Hollinshead, DDS
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• Skilled Nursing Facility in Halstad, MN
• Providers in Halstad, 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 Mar 22, 2012; 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.