Provider Demographics
NPI:1710972112
Name:CENTRAL HEALTH CARE OF LE CENTER, INC.
Entity Type:Organization
Organization Name:CENTRAL HEALTH CARE OF LE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SETH
Authorized Official - Middle Name:
Authorized Official - Last Name:PROBST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-357-2275
Mailing Address - Street 1:444 N CORDOVA AVE
Mailing Address - Street 2:
Mailing Address - City:LE CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:56057-1704
Mailing Address - Country:US
Mailing Address - Phone:507-357-2275
Mailing Address - Fax:507-357-4346
Practice Address - Street 1:444 N CORDOVA AVE
Practice Address - Street 2:
Practice Address - City:LE CENTER
Practice Address - State:MN
Practice Address - Zip Code:56057-1704
Practice Address - Country:US
Practice Address - Phone:507-357-2275
Practice Address - Fax:507-357-4346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-13
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN328184314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN936540100Medicaid
245401Medicare Oscar/Certification