NPIMap

Organization Active NPI

Country Manor Campus LLC

Doing business as Country Manor Extended Services - Woodcrest

  • Home Health Agency
  • Saint Joseph, MN
National Provider Identifier
1942763313
Registry record updated Jun 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
COUNTRY MANOR CAMPUS LLC
Doing business as
Country Manor Extended Services - Woodcrest
Practice address
1200 Lanigan Way SW
Saint Joseph, MN 56374-4732
Phone
(320) 253-3343
Fax
(320) 240-0244
NPI assigned
Apr 11, 2019
Last updated
Jun 30, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
COUNTRY MANOR CAMPUS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 30, 2021

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

Authorized official

Name
Kevin Harguth
Title
C.F.O.
Phone
(320) 258-8983

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

1200 Lanigan Way SW
Saint Joseph, MN 56374-4732

Mailing address

520 1St St NE
Sartell, MN 56377-1274
Phone (320) 258-8983

Other names 1

  • Country Manor Extended Services - Woodcrest Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kharguth@countrymanor.org Direct

National Provider Directory

National Provider Directory
Tax ID family
Country Manor Campus LLC9 organizations share this tax ID, including this one
Part of
Country Manor Campus LLC

Other organizations with this tax ID 8

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

Interoperability endpoints

  • Direct secure messaging: kharguth@countrymanor.org

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1554940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625011200000",
    "number": "1942763313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 1ST ST NE",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563771274",
            "telephone_number": "320-258-8983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 LANIGAN WAY SW",
            "city": "SAINT JOSEPH",
            "state": "MN",
            "postal_code": "563744732",
            "telephone_number": "320-253-3343",
            "fax_number": "320-240-0244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRY MANOR CAMPUS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COUNTRY MANOR CAMPUS LLC",
        "enumeration_date": "2019-04-11",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A",
        "authorized_official_last_name": "HARGUTH",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "C.F.O.",
        "authorized_official_telephone_number": "320-258-8983"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kharguth@countrymanor.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1200 Lanigan Way SW",
            "city": "Saint Joseph",
            "state": "MN",
            "country_code": "US",
            "postal_code": "563744732",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Country Manor Extended Services - Woodcrest",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Country Manor Extended Services - Woodcrest",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Joseph, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; 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.