Healthcare Provider Details

I. General information

NPI: 1437107216
Provider Name (Legal Business Name): AUGUSTANA CHAPEL VIEW HOMES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 04/06/2023
Certification Date: 04/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 MINNETONKA MILLS RD
HOPKINS MN
55343
US

IV. Provider business mailing address

615 MINNETONKA MILLS RD
HOPKINS MN
55343-7289
US

V. Phone/Fax

Practice location:
  • Phone: 952-697-3815
  • Fax:
Mailing address:
  • Phone: 952-697-3815
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number328872
License Number StateMN

VIII. Authorized Official

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