Provider Demographics
NPI:1992040695
Name:AUGUSTANA APARTMENTS OF HASTINGS
Entity Type:Organization
Organization Name:AUGUSTANA APARTMENTS OF HASTINGS
Other - Org Name:PARK RIDGE APARTMENTS OF HASTINGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:KITTELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-238-5205
Mailing Address - Street 1:901 16TH ST W
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:MN
Mailing Address - Zip Code:55033-3355
Mailing Address - Country:US
Mailing Address - Phone:651-480-6300
Mailing Address - Fax:651-480-6348
Practice Address - Street 1:901 16TH ST W
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:MN
Practice Address - Zip Code:55033-3355
Practice Address - Country:US
Practice Address - Phone:651-480-6300
Practice Address - Fax:651-480-6348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-06
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN359418310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility