Faribault Health Care LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

329250 Issued in MN

Legal business name

FARIBAULT HEALTH CARE LLC

Doing business as

St Lucas Care Center

Practice address

500 1St St SE
Faribault, MN 55021-6346

Phone

(507) 332-5100

Fax

(507) 332-5188

NPI assigned

Aug 23, 2005

Last updated

Jan 28, 2009By 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. Bradley Robert Molgard, LCNHA

Title

Administrator

Phone

(507) 332-5100

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• St Lucas Care Center Doing business as

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233100800000",
    "number": "1710970942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 1ST ST SE",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550216346",
            "telephone_number": "507-332-5100",
            "fax_number": "507-332-5188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 1ST ST SE",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550216346",
            "telephone_number": "507-332-5100",
            "fax_number": "507-332-5188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FARIBAULT HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-23",
        "last_updated": "2009-01-28",
        "status": "A",
        "authorized_official_last_name": "MOLGARD",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "507-332-5100",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCNHA"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MN",
            "license": "329214",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MN",
            "license": "329250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "470618800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Lucas Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bisharo Hassan Farah, CHW
• Muse Farah
• Faribault Best Group Corp
• Faribault Care Center
• Faribault Commons Nursing & Rehabilitation, Inc.
• Faribault Ops LLC (Keystone Faribualt)
• Faribault Psychological Services PA
• Faribault Rehabilitation Center
• Faribault Senior Living LLC
• Faribault Wellness Center, P.a.

• Skilled Nursing Facility in Faribault, MN
• Providers in Faribault, 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 Jan 28, 2009; 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.