Oak Terrace Senior Housing of Gaylord,LLC

Primary specialty

Alzheimer Center (Dementia Center)Taxonomy code 311500000X

License

338323 Issued in MN

Legal business name

OAK TERRACE SENIOR HOUSING OF GAYLORD,LLC

Practice address

716 Sibley Ave
Gaylord, MN 55334-2386

Phone

(507) 237-2911

Fax

(507) 237-5744

NPI assigned

Dec 31, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Michael David Montag

Title

President

Phone

(507) 381-1312

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1199059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199059200000",
    "number": "1760667489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1570 TOWER BLVD",
            "city": "NORTH MANKATO",
            "state": "MN",
            "postal_code": "560032520",
            "telephone_number": "507-387-2037",
            "fax_number": "507-387-6011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 SIBLEY AVE",
            "city": "GAYLORD",
            "state": "MN",
            "postal_code": "553342386",
            "telephone_number": "507-237-2911",
            "fax_number": "507-237-5744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAK TERRACE SENIOR HOUSING OF GAYLORD,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-31",
        "last_updated": "2007-12-31",
        "status": "A",
        "authorized_official_last_name": "MONTAG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "507-381-1312",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "MN",
            "license": "338323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Geri Loose
• McGuire Family Chiropractic PA
• McKayla Nicole Narveson
• Kelli Nowak, MA, LPCC
• Oak Terrace Health Care Center of Gaylord ,LLC
• Emily Ayleen Orocio
• Overson Family Based Counseling Services, Inc
• Jaime Petersen, OTR/L
• Carol Polzin
• Belinda Rose Prachar, RN

• Alzheimer Center (Dementia Center) in Gaylord, MN
• Providers in Gaylord, MN by specialty
• Alzheimer Center (Dementia Center) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2007; 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.