Saint Therese of Corcoran, LLC
Organization Active NPI Assisted Living Facility · Corcoran, MN
NPI 1750126397 · NPPES record last updated Jun 26, 2024
Key facts
- NPI
- 1750126397
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Assisted Living Facility 310400000X
- Legal business name
- SAINT THERESE OF CORCORAN, LLC
- Practice address
- 19800 79TH Place
Corcoran, MN 55340 - Phone
- (763) 567-4700
- NPI assigned
- Jun 26, 2024
- Organization subpart
- No
Authorized official
- Name
- Mr. Cal M Shelangoski
- Title
- Chief Financial Officer
- Phone
- (563) 554-7606
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 24D2312934 | Saint Therese of Corcoran-Homecare Services | Certificate of waiver | Oct 21, 2026 |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | Yes |
Addresses
Primary practice location
19800 79TH Place
Corcoran, MN 55340
Mailing address
1660 Highway 100 S Ste 103
Saint Louis Park, MN 55416-1599
Phone (952) 283-2204
Other providers in Corcoran, MN
- Integrated Rd Care
- Amy B Johnson
- Christopher Johnson
- Latasha Larson
- Kim Rose Nelson
- James Peter Seim
- Suite Living Senior Care of Corcoran
- Comfort Wagner
- Weaver Health LLC
All providers in Corcoran, MN · Assisted Living 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 Jun 26, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.