OrganizationActive
Msocs-Shumway
NPI 1912070723 · Intellectual Disabilities Intermediate Care Facility · Faribault, MN
Provider details
- NPI number
- 1912070723
- Entity type
- Organization
- Primary specialty
- Intellectual Disabilities Intermediate Care FacilityNursing & Custodial Care Facilities
- Parent organization
- Eastern Minnesota State Operated Community Services
- Organization subpart
- Yes
- Authorized official
- Roger Deneen, Residential Prog Svcs Director(651) 582-1857
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 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
1805 Shumway Ave
Faribault, MN 55021-3102
Phone: (507) 332-0495
Street-level locationGet directions
Mailing address
Po Box 64979
Saint Paul, MN 55164-0979
Registry dates
- Enumerated
- 2006-11-17
- Last updated
- 2008-06-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.