Steve & Barb Jensen

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

STEVE & BARB JENSEN

Doing business as

Your Home at the Lake

Practice address

36309 Augustana Dr
Battle Lake, MN 56515-9361

Phone

(218) 495-2625

Fax

(218) 736-4250

NPI assigned

Dec 10, 2015

Organization subpart

No

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

Authorized official

Name

Barbara Jensen

Title

Owner

Phone

(218) 495-2625

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Your Home at the Lake Doing business as

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

{
    "created_epoch": "1449705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449705600000",
    "number": "1669847075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36309 AUGUSTANA DR",
            "city": "BATTLE LAKE",
            "state": "MN",
            "postal_code": "565159361",
            "telephone_number": "218-495-2625",
            "fax_number": "218-736-4250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36309 AUGUSTANA DR",
            "city": "BATTLE LAKE",
            "state": "MN",
            "postal_code": "565159361",
            "telephone_number": "218-495-2625",
            "fax_number": "218-736-4250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVE & BARB JENSEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-10",
        "last_updated": "2015-12-10",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "218-495-2625"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN UMIP",
            "identifier": "A356977000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Your Home at the Lake",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Todd S Smith, DDS
• Trisha Stich
• Abby Swanson, PT
• The Evangelical Lutheran Good Samaritan Society (Good Samaritan Society Battle Lake)
• The Evangelical Lutheran Good Samaritan Society (Good Samaritan Society - Battle Lake)
• Amy Marie Toenjes, PT

• Adult Care Home Facility in Battle Lake, MN
• Providers in Battle Lake, 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 10, 2015; 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.