Organization
ST. JOHN LUTHERAN HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSHUA JENSEN (CEO)
(507) 723-3200
Entity
Organization
Contact information
Practice address
201 S COUNTY ROAD 5, SPRINGFIELD, MN 56087-2102
(507) 723-3200
(507) 723-6429
Mailing address
201 S COUNTY ROAD 5, SPRINGFIELD, MN 56087-2102
(507) 723-3200
(507) 723-6429
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
328426
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
346740600
—
MN
01
—
8717 JO
BLUE CROSS PROVIDER
MN
01
—
NH0374
SCHA - UCARE
MN
Enumeration date
09/26/2005
Last updated
06/11/2008
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