Provider Demographics
NPI:1336272210
Name:LUTHERAN HOME BELLE PLAINE, LLC
Entity Type:Organization
Organization Name:LUTHERAN HOME BELLE PLAINE, LLC
Other - Org Name:THE LUTHERAN HOME
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RICK
Authorized Official - Middle Name:JON
Authorized Official - Last Name:KRANT
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:952-873-2131
Mailing Address - Street 1:611 WEST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:BELLE PLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:56011
Mailing Address - Country:US
Mailing Address - Phone:952-873-2100
Mailing Address - Fax:952-873-2120
Practice Address - Street 1:611 WEST MAIN STREET
Practice Address - Street 2:
Practice Address - City:BELLE PLAINE
Practice Address - State:MN
Practice Address - Zip Code:56011
Practice Address - Country:US
Practice Address - Phone:952-873-2100
Practice Address - Fax:952-873-2120
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE LUTHERAN HOME ASSOCIATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-13
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN33896314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN751243100Medicaid
MN245590Medicare Oscar/Certification