NPIMap

Organization Active NPI

Country Manor Campus LLC

  • Skilled Nursing Facility
  • Sartell, MN
National Provider Identifier
1952575011
Registry record updated Jun 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
COUNTRY MANOR CAMPUS LLC
Practice address
520 1St St NE
Sartell, MN 56377-1274
Phone
(320) 253-1920
NPI assigned
Apr 18, 2008
Organization subpart
Yes
Parent organization
THE FOUNDATION FOR HEALTH CARE CONTINUUMSAs reported in NPPES

Authorized official

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

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 19

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 19

Care Compare: Nursing home

Medicare Care Compare
Listed as
Country Manor Healthcare and Rehab CenterCCN 245330
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
5 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Jul 1, 1986
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
131119.5 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080716000856 MN Part A Provider - Skilled Nursing Facility 7113090648 Practice locations: Sartell, MN

Skilled nursing facility certification: CCN 245330

Legal name
COUNTRY MANOR CAMPUS LLC
Doing business as
COUNTRY MANOR HEALTH AND REHAB CENTER / CHAMPION REHAB
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 1, 1986
Last certification
Jan 23, 2025
Beds
131
Ownership / control type
Nonprofit Corporation
Organization structure
LLCNon-profit
Incorporated
Jan 28, 2008 in TN
Enrollment address
520 1St Street NE
Sartell, MN 56377-1274
Nursing home name
COUNTRY MANOR HEALTHCARE AND REHAB CENTER

All disclosed owners & managing parties 9

Medicare enrollment files

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Fred Taylor Brown Individual Corporate DirectorBoard Member Secretary Aug 1, 1998
Sherry Madden Wheaton Individual Corporate DirectorBoard Member Aug 1, 1998
Michael Phillip Rosen Individual Corporate DirectorBoard Member President Aug 1, 1998
Operational/Managerial Control Jan 1, 2013
Paul Sidney Sanders Individual Corporate DirectorBoard Member Aug 1, 1998
Continuums Management Services LLC Organization, Sartell, MN LLC Operational/Managerial Control Jan 1, 2013 100%
Anthony G Fenstad Individual Corporate OfficerCeo Jul 22, 2024 100%
Operational/Managerial ControlCeo Jul 22, 2024 100%
Kevin Gerard Harguth Individual Corporate OfficerCfo Jan 11, 2018
Operational/Managerial ControlCfo Jan 11, 2018
Foundation for Health Care Continuums Organization, Sartell, MN Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jul 1, 2008 100%
Felix Anthony Fraraccio Individual Corporate DirectorBoard Member Aug 1, 1998

National Provider Directory

National Provider Directory
Tax ID family
Country Manor Campus LLC9 organizations share this tax ID, including this one
Part of
Foundation for Health Care Continuums

Other organizations with this tax ID 8

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

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

NPPES NPI Registry

Primary practice location

520 1St St NE
Sartell, MN 56377-1274

Mailing address

520 1St St NE
Sartell, MN 56377-1274
Phone (320) 253-1920

Other names 1

NPPES NPI Registry
  • Country Manor Health and Rehab Center Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 30, 2021.

{
    "created_epoch": "1208476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625011200000",
    "number": "1952575011",
    "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": "320-253-1920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 1ST ST NE",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563771274",
            "telephone_number": "320-253-1920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRY MANOR CAMPUS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE FOUNDATION FOR HEALTH CARE CONTINUUMS",
        "enumeration_date": "2008-04-18",
        "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": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Country Manor Health and Rehab Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Country Manor Health and Rehab Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sartell, MN

Sources for this page

Verify at the official NPI Registry.