Healthcare Provider Details

I. General information

NPI: 1952372856
Provider Name (Legal Business Name): ST LUKE'S LUTHERAN CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 05/11/2020
Certification Date: 05/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1219 S RAMSEY ST
BLUE EARTH MN
56013-2227
US

IV. Provider business mailing address

1219 S RAMSEY ST
BLUE EARTH MN
56013-2227
US

V. Phone/Fax

Practice location:
  • Phone: 507-526-2184
  • Fax: 507-526-7427
Mailing address:
  • Phone: 507-526-2184
  • Fax: 507-526-7427

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number328240
License Number StateMN

VIII. Authorized Official

Name: MS. MARGARET BRANDT
Title or Position: CEO/ADMINISTRATOR
Credential:
Phone: 507-526-6301