Provider Demographics
NPI:1487648598
Name:LUTHERAN HOMES
Entity type:Organization
Organization Name:LUTHERAN HOMES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARI
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCHREINER
Authorized Official - Suffix:
Authorized Official - Credentials:EXECUTIVE DIRECTOR,
Authorized Official - Phone:218-584-5181
Mailing Address - Street 1:PO BOX 480
Mailing Address - Street 2:208 OPPEGARD AVE NW
Mailing Address - City:TWIN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:56584-0480
Mailing Address - Country:US
Mailing Address - Phone:218-584-5181
Mailing Address - Fax:218-584-5304
Practice Address - Street 1:208 OPPEGARD AVE NW
Practice Address - Street 2:
Practice Address - City:TWIN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:56584-0480
Practice Address - Country:US
Practice Address - Phone:218-584-5181
Practice Address - Fax:218-584-5304
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LUTHERAN HOMES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-09-02
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN328507310400000X
314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN546242800Medicaid
MN9751 LUOtherBLUE CROSS & BLUE SHIELD
ND030221Medicaid
MN71-22703OtherMEDICA PROVIDER NUMBER
MNNH 0586OtherUCARE MINNESOTA
MN71-22703OtherMEDICA PROVIDER NUMBER
MNNH 0586OtherUCARE MINNESOTA