Provider Demographics
NPI:1699225920
Name:NEXT STEPS TRANSITIONAL NURSING HOUSING RE ENTRY
Entity Type:Organization
Organization Name:NEXT STEPS TRANSITIONAL NURSING HOUSING RE ENTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LASHAWN
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:FALE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:320-980-1999
Mailing Address - Street 1:1025 18TH ST N
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-1205
Mailing Address - Country:US
Mailing Address - Phone:320-980-1999
Mailing Address - Fax:
Practice Address - Street 1:2605 11TH ST. N.
Practice Address - Street 2:
Practice Address - City:ST. CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303
Practice Address - Country:US
Practice Address - Phone:320-980-1999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-11
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN142983-9163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty