OrganizationActive
Lutheran Social Service of Minnesota
NPI 1114385085 · Intellectual Disabilities Intermediate Care Facility · Elk River, MN
Provider details
- NPI number
- 1114385085
- Entity type
- Organization
- Primary specialty
- Intellectual Disabilities Intermediate Care FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Brigid Peterson, Chief Compliance & Integration(651) 310-9451
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
11754 191 1/2 Ave Nw
Elk River, MN 55330-1367
Phone: (651) 310-9451
Approximate (ZIP-level) locationGet directions
Mailing address
2485 Como Ave
Saint Paul, MN 55108-1445
Registry dates
- Enumerated
- 2016-02-05
- Last updated
- 2017-02-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.