Benedictine Care Centers

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

331733 Issued in MN

Legal business name

BENEDICTINE CARE CENTERS

Practice address

213 Pioneer Rd
Red Wing, MN 55066-3921

Phone

(651) 388-1234

Fax

(651) 385-5444

NPI assigned

Oct 26, 2006

Organization subpart

Yes

Parent organization

BENEDICTINE CARE CENTERSAs reported in NPPES

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

Authorized official

Name

Jake Goering

Title

Administrator/Ceo

Phone

(651) 385-3435

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• St. Crispin Living Community - The Villa Doing business as

Tax ID family

Benedictine Care Centers2 organizations share this tax ID, including this one

Part of

Benedictine Care Centers

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Benedictine Care Centers

  • Skilled Nursing Facility
  • New Brighton, MN
  • NPI 1336135524
  NPD tax ID

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560470400000",
    "number": "1730264607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 PIONEER RD",
            "city": "RED WING",
            "state": "MN",
            "postal_code": "550664217",
            "telephone_number": "651-388-1234",
            "fax_number": "651-388-0347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 PIONEER RD",
            "city": "RED WING",
            "state": "MN",
            "postal_code": "550663921",
            "telephone_number": "651-388-1234",
            "fax_number": "651-385-5444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENEDICTINE CARE CENTERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BENEDICTINE CARE CENTERS",
        "enumeration_date": "2006-10-26",
        "last_updated": "2019-06-14",
        "status": "A",
        "authorized_official_last_name": "GOERING",
        "authorized_official_first_name": "JAKE",
        "authorized_official_title_or_position": "ADMINISTRATOR/CEO",
        "authorized_official_telephone_number": "651-385-3435"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MN",
            "license": "331733",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "377175000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Crispin Living Community - The Villa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kristine Beil
• Lucinda G Beise, COTA
• Laurie J Bell
• Benedictine Care Centers
• Benedictine Care Centers
• Jeri Lynn Benser, RN
• Brian R Bergan, DDS
• Jeremy Scott Berger, D.D.S.
• Sarah Joy Berhow, APRN, CNP
• Marc E Bettich, MD

• All providers in Red Wing, MN
• Assisted Living Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2019; 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.