Provider Demographics
NPI:1649970484
Name:SHEPHERDS INN ASSISTED LIVING INC
Entity type:Organization
Organization Name:SHEPHERDS INN ASSISTED LIVING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:SCHROEDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-388-2888
Mailing Address - Street 1:64667 150TH ST
Mailing Address - Street 2:
Mailing Address - City:ALDEN
Mailing Address - State:MN
Mailing Address - Zip Code:56009-5550
Mailing Address - Country:US
Mailing Address - Phone:701-388-2888
Mailing Address - Fax:507-299-9911
Practice Address - Street 1:46 1ST AVE SW
Practice Address - Street 2:
Practice Address - City:WELLS
Practice Address - State:MN
Practice Address - Zip Code:56097-1932
Practice Address - Country:US
Practice Address - Phone:507-553-6217
Practice Address - Fax:507-553-6830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-09
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility