Healthcare Provider Details

I. General information

NPI: 1821092875
Provider Name (Legal Business Name): BENEDICTINE LIVING COMMUNITY OF ST. PETER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2005
Last Update Date: 02/20/2025
Certification Date: 02/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1907 KLEIN ST
SAINT PETER MN
56082-5801
US

IV. Provider business mailing address

627 PARK ROW
ST PETER MN
56082-1336
US

V. Phone/Fax

Practice location:
  • Phone: 507-934-2203
  • Fax: 507-934-8392
Mailing address:
  • Phone: 507-934-2203
  • Fax: 507-931-7333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number327205
License Number StateMN

VIII. Authorized Official

Name: TERESA M HILDEBRANDT
Title or Position: ADMINISTRATOR/CEO
Credential:
Phone: 507-934-2203