MEDICARE: ELIM HOMES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA0600X	Adult Day Care Clinic/Center
2	314000000X	Skilled Nursing Facility	328424	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	328424	OTHER	MN	STATE LICENSE NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881682680
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELIM HOMES, INC.

Provider Business Mailing Address
First Line	:	701 1ST ST
Second Line	:
City	:	PRINCETON
State	:	MN
Zip	:	55371-1713
Country	:	US
Telephone Number	:	763-389-1171
Fax Number	:	763-389-0432

Provider Business Practice Location Address
First Line	:	701 1ST ST
Second Line	:
City	:	PRINCETON
State	:	MN
Zip	:	55371-1713
Country	:	US
Telephone Number	:	763-389-1171
Fax Number	:	763-389-0432

Authorized Official
Title or Position	:	ASSOCIATE VP OF REVENUE CYCLE MGMT
Name	:	SEELOCHANI STADTHERR
Credential	:
Telephone Number	:	952-855-5041

Provider Enumeration Date	:	10/06/2005
Last Update Date	:	11/21/2025

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Directions to “ELIM HOMES, INC. ” Practice Location

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