Organization
LUTHERAN CARE CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HERMAN JOHANNES (PRESIDENT)
(320) 632-9211
Entity
Organization
Contact information
Practice address
1200 1ST AVE NE, LITTLE FALLS, MN 56345-3309
(320) 632-9211
(320) 632-2097
Mailing address
1200 1ST AVE NE, LITTLE FALLS, MN 56345-3309
(320) 632-9211
(320) 632-2097
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
331606
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
615542100
—
MN
01
—
71-22644
MEDICA
MN
01
—
9617LU
BLUE CROSS BLUE SHIELD
MN
Enumeration date
07/13/2006
Last updated
03/08/2012
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