Provider Demographics
NPI:1194021600
Name:BENEDICTINE LIVING COMMUNITY OF WINSTED
Entity Type:Organization
Organization Name:BENEDICTINE LIVING COMMUNITY OF WINSTED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GAMALDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-485-2151
Mailing Address - Street 1:551 4TH ST N
Mailing Address - Street 2:
Mailing Address - City:WINSTED
Mailing Address - State:MN
Mailing Address - Zip Code:55395-4523
Mailing Address - Country:US
Mailing Address - Phone:320-485-2151
Mailing Address - Fax:320-485-4241
Practice Address - Street 1:551 4TH ST N
Practice Address - Street 2:
Practice Address - City:WINSTED
Practice Address - State:MN
Practice Address - Zip Code:55395-4523
Practice Address - Country:US
Practice Address - Phone:320-485-2151
Practice Address - Fax:320-485-4241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-31
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
245459Medicare Oscar/Certification