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VOP SOUTH GROVE LODGE LLC NPI 1295494110


NPI Information

NPI: 1295494110
Provider Name: VOP SOUTH GROVE LODGE, LLC
Classification: Custodial Care Facility - 311ZA0620X
Entity Type: Organization

Specialization: Adult Care Home

Address:
1701 22ND AVE SW
AUSTIN, MN
ZIP 55912
Phone: (507) 396-4960
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VOP SOUTH GROVE LODGE, LLC is an adult care home custodial care facility in Austin, MN. The provider is a custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. VOP SOUTH GROVE LODGE, LLC NPI is 1295494110. The provider is registered as an organization entity type.

The provider's business location address is:

1701 22ND AVE SW
AUSTIN, MN
ZIP 55912-798
Phone: (507) 396-4960
Fax: (507) 434-0041

The provider's authorized official is Terri Lynn Baker .
The authorized official title is Finance And Licensing Coordinator and has the following contact phone number (503) 998-5810.

The enumeration date for this NPI number is 12/8/2021 and was last updated on 12/8/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1311ZA0620XCustodial Care FacilityAdult Care HomeYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1404147OTHERMINNESOTAMINNESOTA DEPARTMENT OF HEALTH (MDH) - ELDERLY WAIVER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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