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General NPI Number Information
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NPI Number | 1376676908
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Entity Type | Organization
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Legal Business Name | LUTHERAN HOME BELLE PLAINE LLC
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 04/18/2017
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Provider Practice Location Address
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Address Line | 611 W MAIN ST
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City | BELLE PLAINE
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State | MN
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Zip | 56011-1221
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Country | US
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Telephone | 952-873-2143
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Fax | 952-873-2147
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Provider Business Mailing Address
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Address Line | 611 W MAIN ST
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City | BELLE PLAINE
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State | MN
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Zip | 56011-1221
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Country | US
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Telephone | 952-873-2142
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Fax | 952-873-2147
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Authorized Official
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Title or Position | CFO
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Name | MARY SUE MEGER
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Credential | CPA
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Telephone | 952-873-4758
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number | 334809
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License Number State | MN
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