Itasca Nursing Home
NPI 1184662793 · Skilled Nursing Facility · Grand Rapids, MN
Enrolled with Medicare as Part a Provider - Skilled Nursing Facility · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Itasca Nursing Home is a Skilled Nursing Facility organization in Grand Rapids, MN (NPI 1184662793).
Provider details
- NPI number
- 1184662793
- Entity type
- Organization
- Primary specialty
- Skilled Nursing FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Jacob Goering, Executive Director(218) 322-4777
- License
- 331920 (MN)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Grand Village
Registry dates
- Enumerated
- 2006-06-04
- Last updated
- 2020-08-22
Frequently asked questions
- What is Itasca Nursing Home's NPI number?
- Itasca Nursing Home's National Provider Identifier (NPI) is 1184662793, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Itasca Nursing Home?
- Itasca Nursing Home is classified in the NPPES registry as Skilled Nursing Facility (Nursing & Custodial Care Facilities).
- Where is Itasca Nursing Home located?
- Itasca Nursing Home's practice location on file with NPPES is 923 Hale Lake Pointe, Grand Rapids, MN 55744-9615.
- What is Itasca Nursing Home's phone number?
- The practice phone number listed in the NPPES registry for Itasca Nursing Home is (218) 326-0543.
- Does Itasca Nursing Home accept Medicare?
- Itasca Nursing Home is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Itasca Nursing Home?
- The authorized official listed on Itasca Nursing Home's NPPES record is Jacob Goering, Executive Director. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Itasca Nursing Home's NPI active?
- Yes — Itasca Nursing Home's NPI (1184662793) is active in the NPPES registry as of the last update on 2020-08-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.