Provider Demographics
NPI:1760903157
Name:ST. JOHN'S LUTHERAN HOME
Entity Type:Organization
Organization Name:ST. JOHN'S LUTHERAN HOME
Other - Org Name:ST. JOHN'S LUTHERAN COMMUNITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REIMBURSEMENT COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINETTE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:KLEINSCHRODT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:507-373-8226
Mailing Address - Street 1:901 LUTHER PL
Mailing Address - Street 2:
Mailing Address - City:ALBERT LEA
Mailing Address - State:MN
Mailing Address - Zip Code:56007-1562
Mailing Address - Country:US
Mailing Address - Phone:057-473-1015
Mailing Address - Fax:507-379-9506
Practice Address - Street 1:1771 EAGLE VIEW CIR
Practice Address - Street 2:
Practice Address - City:ALBERT LEA
Practice Address - State:MN
Practice Address - Zip Code:56007-1817
Practice Address - Country:US
Practice Address - Phone:507-373-8226
Practice Address - Fax:507-379-9506
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. JOHN'S LUTHERAN HOME
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-07-06
Last Update Date:2017-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility