Organization
HALSTAD LIVING CENTER
Active
Parent organization
LUTHERAN HOMES
Other names
Halstad Living Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
LUTHERAN HOMES
Authorized official
MR. DWIGHT A FUGLIE LICENSED ADM. (EXECUTIVE DIRECTOR)
(218) 456-2105
Entity
Organization
Contact information
Practice address
133 4TH AVE E, HALSTAD, MN 56548-4114
(218) 456-2105
(218) 456-2290
Mailing address
133 4TH AVE E, HALSTAD, MN 56548-4114
(218) 456-2105
(218) 456-2290
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
328227
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
075740300
—
MN
01
—
23605
ND BLUE CROSS AND BLUE SH
ND
05
—
30280
—
ND
01
—
7122758
MEDICA INSURANCVE
MN
01
—
9506 HA
MN BC-BS
MN
Enumeration date
10/11/2005
Last updated
03/22/2012
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