Provider Demographics
NPI:1437192275
Name:ST. ANTHONY NURSING HOME LIMITED PARTNERSHIP
Entity Type:Organization
Organization Name:ST. ANTHONY NURSING HOME LIMITED PARTNERSHIP
Other - Org Name:ST. ANTHONY HEALTH & REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:WEICHERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-361-8000
Mailing Address - Street 1:1107 HAZELTINE BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHASKA
Mailing Address - State:MN
Mailing Address - Zip Code:55318-1009
Mailing Address - Country:US
Mailing Address - Phone:952-361-8000
Mailing Address - Fax:952-361-8058
Practice Address - Street 1:3700 FOSS RD
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55421-4512
Practice Address - Country:US
Practice Address - Phone:612-913-5304
Practice Address - Fax:612-788-0104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN329079310400000X
MN328175314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN8666ANOtherBCBS
MN266OtherHEALTH PARTNERS
MN369742800Medicaid
MN71-11817OtherMEDICA/FAIRVIEW PARTNERS
MN620063000OtherELDER WAIVER
MNNH0090OtherUCARE/FAIRVIEW PARTNERS
MN71-00060OtherMEDICA
MN8666ANOtherBCBS
MN71-11817OtherMEDICA/FAIRVIEW PARTNERS