Healthcare Provider Details

I. General information

NPI: 1205884004
Provider Name (Legal Business Name): AUGUSTANA HEALTH CARE CENTER OF HASTINGS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 06/23/2021
Certification Date: 06/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 16TH ST W
HASTINGS MN
55033-3335
US

IV. Provider business mailing address

930 16TH ST W
HASTINGS MN
55033-3335
US

V. Phone/Fax

Practice location:
  • Phone: 651-480-5900
  • Fax:
Mailing address:
  • Phone: 651-437-6176
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number326933
License Number StateMN

VIII. Authorized Official

Name: SEELOCHANI STADTHERR
Title or Position: DIRECTOR OF REIMBURSEMENT
Credential:
Phone: 952-855-5041