EAST VERNON RESIDENCE LLC (NPI# 1376027672) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376027672 |
| Entity Type | Organization |
| Organization Name | EAST VERNON RESIDENCE LLC |
| Practice Address |
218 E Vernon Ave Fergus Falls MN 56537-2924 |
| Practice Telephone | 8152570020 |
| Mailing Telephone | 8152570020 |
| Enumeration Date | 2018-09-21 |
| Last Update Date | 2018-09-21 |
| Authorized Official Name | MRS. BETH ALISON CLARKSON (PRESIDENT) |
| Authorized Official Telephone | 8152570020 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 253J00000X | Foster Care Agency | Agencies |
| Street Address |
218 E VERNON AVE |
| City | FERGUS FALLS |
| State | MN |
| Zip Code | 56537-2924 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295334217 | Mary Jane Andersen | Pharmacist | 3300 Hwy 210 W, Fergus Falls, MN 56537 | 2020-10-21 |
| 1609475615 | Blaine Perry Ecker | Pharmacist | 3300 Highway 210 W., 3300 Highway 210 West, Fergus Falls, MN 56537 | 2020-10-21 |
| 1336771591 | Paul George Wawin | Psychiatry & Neurology | 712 Cascade St. S. Lake Region Healthcare, Fergus Falls, MN 56537 | 2020-02-06 |
| 1134604127 | Christopher Michael Kjolhaug | Physical Therapist | 1131 South Mabelle Ave, Fergus Falls, MN 56537 | 2018-09-26 |
| 1619406808 | Aaron John Teigen | Physical Therapist | 1304 Lincoln Ave W, Suite C, Fergus Falls, MN 56537 | 2017-06-09 |
| 1003272154 | Anthony Gettel Dc LLC | Chiropractor | 755 Wildwood Trail, Fergus Falls, MN 56537 | 2016-01-05 |
| 1447628912 | Kelsey Shea | Student in an Organized Health Care Education/Training Program | 20743 Red Oak Dr., Fergus Falls, MN 56537 | 2015-09-14 |
| 1881070217 | Vineet Ganapati | Dentist | 2001 W Lincoln Ave # 33, Fergus Falls, MN 56537 | 2015-08-07 |
| 1497004832 | Beverly Renae Reiff | Registered Nurse | 22279 River Oaks Drive, Fergus Falls, MN 56537 | 2012-08-30 |
| 1114221421 | Jane Mary Bjornson | Social Worker | 21081 County Hwy 1, Fergus Falls, MN 56537 | 2010-12-29 |
| Find all providers in zip 56537 | ||||
| Taxonomy Code | 253J00000X |
| Grouping | Agencies |
| Classification | Foster Care Agency |
| A Foster Care Agency is an agency that provides foster care as defined in the Code of Federal Regulations (CFR) as "24-hour substitute care for children outside their own homes." Foster care settings include, but are not limited to, nonrelative foster family homes, relative foster homes (whether payments are being made or not), group homes, emergency shelters, residential facilities, and pre-adoptive homes. |
| Notes: Source: Code Of Federal Regulations, Title 45, Volume 4, Part 1355, Section 57 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336495902 | Wendy Rae Digre | Foster Care Agency | 228 W Adolphus Ave, Fergus Falls, MN 56537-3405 | 2012-08-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659979979 | South Star Care | Foster Care Agency | 3973 Willow Ridge Dr Sw, Rochester, MN 55902-2801 | 2020-10-09 |
| 1174138218 | Angelique Elizabeth Finifrock | Foster Care Agency | 10701 Becks Rd, Duluth, MN 55808 | 2020-09-15 |
| 1881211951 | Nordell Family Services LLC | Foster Care Agency | 4626 20th St Sw, Waverly, MN 55390-5004 | 2020-07-06 |
| 1285260497 | Yasmin Ahmed Sulayman | Foster Care Agency | 3433 Kenosha Dr Nw, Rochester, MN 55901-5707 | 2020-03-19 |
| 1023657285 | Julia Marie Bolte | Foster Care Agency | 3629 152nd Ln Nw, Andover, MN 55304-3008 | 2020-01-04 |
| 1730722745 | Grace Jepchirchir Fidalgo | Foster Care Agency | 6222 Hedgecroft Ave S, Cottage Grove, MN 55016-6002 | 2019-10-22 |
| 1467094102 | Lake Country Living Services LLC | Foster Care Agency | 181 Little Rock Rd Nw, Rice, MN 56367-8685 | 2019-10-15 |
| 1518508712 | Amanda Hesse | Foster Care Agency | 775 Lee Cir Se, Cokato, MN 55321-4697 | 2019-09-30 |
| 1275181661 | Alliance Homes Corporation | Foster Care Agency | 4946 Jackson St Ne, Columbia Heights, MN 55421-1709 | 2019-08-28 |
| 1760048078 | Kevin Carlyle Lunde X | Foster Care Agency | 1321 Merrywood Ct, Faribault, MN 55021-6529 | 2019-05-13 |
| Find all providers with the same taxonomy | ||||
| City | FERGUS FALLS |
| Zip Code | 56537 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.