Vop Mankato Lodge, LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

VOP MANKATO LODGE, LLC

Doing business as

Mankato Lodge Senior Living

Practice address

1360 Adams St
Mankato, MN 56001-4298

Phone

(866) 224-4789

Fax

(507) 388-2153

NPI assigned

Dec 8, 2021

Last updated

Dec 8, 2021By 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

Ms. Terri Lynn Baker

Title

Finance and Licensing Coordinator

Phone

(503) 998-5810

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mankato Lodge Senior Living Doing business as

Electronic endpoints 1

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

CLIA laboratory certificates

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

{
    "created_epoch": "1638921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638921600000",
    "number": "1659030575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5101 NE 82ND AVE STE 200",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626343",
            "telephone_number": "360-254-9442",
            "fax_number": "360-254-1770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 ADAMS ST",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560014298",
            "telephone_number": "866-224-4789",
            "fax_number": "507-388-2153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VOP MANKATO LODGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-08",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "TERRI",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "FINANCE AND LICENSING COORDINATOR",
        "authorized_official_telephone_number": "503-998-5810",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MINNESOTA DEPARTMENT OF HEALTH (MDH) - ELDERLY WAIVER",
            "identifier": "404273",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Mankato",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1360 Adams St",
            "city": "Mankato",
            "state": "MN",
            "country_code": "US",
            "postal_code": "560014298",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Mankato Lodge Senior Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Adult Care Home Facility in Mankato, MN
• Providers in Mankato, MN by specialty
• Adult Care Home Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.