Episcopal Group Homes, Inc.

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

800746-1-RS Issued in MN

Legal business name

EPISCOPAL GROUP HOMES, INC.

Practice address

522 Shadyway Rd
Wayzata, MN 55391-1109

Phone

(952) 475-0089

NPI assigned

Dec 18, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Dexter Andrews

Title

Executive Director

Phone

(952) 475-1621

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710040308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 ARLINGTON CIR",
            "city": "WAYZATA",
            "state": "MN",
            "postal_code": "553911813",
            "telephone_number": "952-475-1621",
            "fax_number": "952-475-2889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 SHADYWAY RD",
            "city": "WAYZATA",
            "state": "MN",
            "postal_code": "553911109",
            "telephone_number": "952-475-0089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EPISCOPAL GROUP HOMES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ANDREWS",
        "authorized_official_first_name": "DEXTER",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "952-475-1621",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "MN",
            "license": "800746-1-RS",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.