Grand Meadow Healthcare Center, Inc
Organization Active NPI Skilled Nursing Facility · Grand Meadow, MN
NPI 1740278282 · NPPES record last updated Oct 20, 2008
Key facts
- NPI
- 1740278282
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 0029853 (MN)
- Legal business name
- GRAND MEADOW HEALTHCARE CENTER, INC
- Practice address
- 210 Grand Ave W
Grand Meadow, MN 55936-1105 - Phone
- (507) 754-5226
- NPI assigned
- Oct 10, 2005
- Organization subpart
- No
Authorized official
- Name
- Howie Groff
- Title
- President
- Phone
- (952) 888-2923
Owners & managing parties with NPI records 1
-
Sara T Medina-Bielski, M.D.
Facilities with the same owner 31
Practitioners 1
-
Sara T Medina-Bielski, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Skilled nursing facility certification: CCN 245367A
- Legal name
- GRAND MEADOW HEALTHCARE CENTER, INC
- Doing business as
- GRAND MEADOW SENIOR LIVING
- Organization structure
- Corporation · Proprietary
- Incorporated
- Sep 23, 1996 in MN
- Enrollment address
- 210 E Grand Ave
Grand Meadow, MN 55936-1105 - Nursing home name
- MEADOW MANOR
- Affiliated entity
- ACCURA HEALTHCARE
All disclosed owners & managing parties 7
| Name | Role | Since | Share |
|---|---|---|---|
| American Healthcare Management Services LLC |
Operational/Managerial Control | Oct 1, 2019 | |
| Sara T Medina-Bielski |
W-2 Managing Employee |
May 1, 2024 | |
| Ted a Leneave |
Corporate Officer |
Oct 1, 2019 | |
| Operational/Managerial Control |
Oct 1, 2019 | ||
| Gail Sheridan |
5% Or Greater Indirect Ownership Interest | Aug 30, 1995 | 50% |
| Tealwood Enterprise Inc |
5% Or Greater Direct Ownership Interest | May 31, 2013 | 100% |
| Trent Maloney |
W-2 Managing Employee |
Jan 1, 2023 | |
| Howard a Groff |
5% Or Greater Indirect Ownership Interest | Aug 30, 1995 | 50% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20081013000380 | MN | Part a Provider - Skilled Nursing Facility | 7012085400 | Practice locations: Grand Meadow, MN |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | 326959 | MN | |
| Skilled Nursing Facility | 314000000X | 0029853 | MN | Yes |
Addresses
Primary practice location
210 Grand Ave W
Grand Meadow, MN 55936-1105
Mailing address
210 Grand Ave W
PO Box 365
Grand Meadow, MN 55936-1105
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 796132400 | Medicaid | MN | |
| 8692ME | Other | MN | BLUE CROSS BLUE SHIELD |
| 346314100 | Medicaid | MN | |
| 7100405 | Other | MN | MEDICA |
Other providers in Grand Meadow, MN
- City of Grand Meadow
- Dillon Carter Denisen
- Gerald Lee Denisen
- Abigail Erickson
- Grand Meadow School District
- Teresa Marie Hanson
- Meadow Area Chiropractic LLC
- Riley Queensland
All providers in Grand Meadow, MN · Skilled Nursing Facility in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 20, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.