Healthcare Provider Details

I. General information

NPI: 1205824968
Provider Name (Legal Business Name): ELIM HOMES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2005
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 CENTRAL AVE
BUFFALO MN
55313-1569
US

IV. Provider business mailing address

19 CENTRAL AVE
BUFFALO MN
55313-1569
US

V. Phone/Fax

Practice location:
  • Phone: 952-955-2242
  • Fax: 952-955-2010
Mailing address:
  • Phone: 952-955-2242
  • Fax: 952-955-2010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number246546
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number246546
License Number StateMN
# 3
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number246546
License Number StateMN

VIII. Authorized Official

Name: SEELOCHANI STADTHERR
Title or Position: AVP, REVENUE CYCLE MANAGEMENT
Credential:
Phone: 952-855-5041