Saint Therese of Corcoran, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 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

Last updated

Jun 26, 2024By 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. Cal M Shelangoski

Title

Chief Financial Officer

Phone

(563) 554-7606

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1719360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719360000000",
    "number": "1750126397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1660 HIGHWAY 100 S STE 103",
            "city": "SAINT LOUIS PARK",
            "state": "MN",
            "postal_code": "554161599",
            "telephone_number": "952-283-2204",
            "fax_number": "952-224-0128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19800 79TH PLACE",
            "city": "CORCORAN",
            "state": "MN",
            "postal_code": "55340",
            "telephone_number": "763-567-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT THERESE OF CORCORAN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-26",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-18",
        "status": "A",
        "authorized_official_last_name": "SHELANGOSKI",
        "authorized_official_first_name": "CAL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "563-554-7606",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy B Johnson, MSW, LICSW
• Christopher Johnson
• Latasha Larson, OT
• Kim Rose Nelson
• Prime Recovery LLC
• James Peter Seim, DC, DACBN
• Suite Living Senior Care of Corcoran
• Comfort Wagner, D.C.
• Weaver Health LLC

• Assisted Living Facility in Corcoran, MN
• Providers in Corcoran, MN by specialty
• Assisted Living Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.