Provider Demographics
NPI:1144215252
Name:NEW RICHLAND CARE CENTER
Entity Type:Organization
Organization Name:NEW RICHLAND CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-465-3292
Mailing Address - Street 1:312 1ST ST NE
Mailing Address - Street 2:PO BOX 477
Mailing Address - City:NEW RICHLAND
Mailing Address - State:MN
Mailing Address - Zip Code:56072-2003
Mailing Address - Country:US
Mailing Address - Phone:507-465-3292
Mailing Address - Fax:507-465-3403
Practice Address - Street 1:312 1ST ST NE
Practice Address - Street 2:
Practice Address - City:NEW RICHLAND
Practice Address - State:MN
Practice Address - Zip Code:56072-2003
Practice Address - Country:US
Practice Address - Phone:507-465-3292
Practice Address - Fax:507-465-3403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN327715314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN245316Medicare ID - Type Unspecified