Provider Demographics
NPI:1295797702
Name:SAINT THERESE OF NEW HOPE
Entity type:Organization
Organization Name:SAINT THERESE OF NEW HOPE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CAL
Authorized Official - Middle Name:M
Authorized Official - Last Name:SHELANGOSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-283-2204
Mailing Address - Street 1:8000 BASS LAKE RD
Mailing Address - Street 2:
Mailing Address - City:NEW HOPE
Mailing Address - State:MN
Mailing Address - Zip Code:55428-3118
Mailing Address - Country:US
Mailing Address - Phone:763-531-5093
Mailing Address - Fax:763-531-5411
Practice Address - Street 1:8000 BASS LAKE RD
Practice Address - Street 2:
Practice Address - City:NEW HOPE
Practice Address - State:MN
Practice Address - Zip Code:55428-3118
Practice Address - Country:US
Practice Address - Phone:763-531-5093
Practice Address - Fax:763-531-5411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-03
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN328241314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNNH0055OtherUCARE HMO
MN8750THOtherBLUE CROSS BLUE SHIELD
MN7122592OtherMEDICA HMO
MN712242000Medicaid
MN269OtherHEALTH PARTNERS HMO
MN8750THOtherBLUE CROSS BLUE SHIELD