EVENTIDE (NPI# 1487705653) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487705653 |
| Entity Type | Organization |
| Organization Name | EVENTIDE |
| Practice Address |
1405 7th St S Moorhead MN 56560-3444 |
| Practice Telephone | 2182337508 |
| Practice Fax Number | 2182333602 |
| Mailing Telephone | 2182337508 |
| Mailing Fax Number | 2182333602 |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. WADE E STUBSON (CFO) |
| Authorized Official Telephone | 2182912216 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 310400000X | Assisted Living Facility | 332819 | MN | Nursing & Custodial Care Facilities |
| X | 314000000X | Skilled Nursing Facility | 00072 | MN | Nursing & Custodial Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417944265 | Eventide | Custodial Care Facility | 114 S 20th St, Denison, IA 51442-2251 | 2005-10-05 |
| 1942538608 | Eventide | Skilled Nursing Facility | 125 13th Ave W, West Fargo, ND 58078-3356 | 2009-11-18 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Eventide | 5 Manor House Rd, Littleton, CO 80127 |
| Virginia Business Entities | Eventide Aquaculture Inc. | 3200 Pacific Ave Suite 100, Virginia Beach, Virginia 23451 |
| Massachusetts Corporations | EVENTIDE ARTS, INC. | 713 Main St., Dennis, MA 02638 |
| North Carolina Corporations | Eventide Asset Management LLC | One International Place Suite 3510, Boston, MA 02110 |
| Colorado Business Entities | Eventide Asset Management, LLC | One International Place, Suite 3510, Boston, MA 02110 |
| Oregon Corporations, Companies and Business Names | EVENTIDE ASSET MANAGEMENT, LLC | One International Place, Suite 3510, Boston, MA 02110 |
| Washington State Corporations | EVENTIDE ASSET MANAGEMENT, LLC | 1 International Pl Ste 3510, Boston, MA 02110-2602 |
| Washington State Corporations | EVENTIDE CONSULTING LLC | 7410 Venteian Way, Lake Clarke Shores, FL 33406 |
| Massachusetts Corporations | EVENTIDE ENTERPRISES, INC. | 70 Marstons Ave., Hyannisport, MA 02647 |
| Washington State Corporations | EVENTIDE HEALTH PLLC | 810 Sunday Dr, Friday Harbor, WA 98250-7300 |
| Street Address |
1405 7TH ST S |
| City | MOORHEAD |
| State | MN |
| Zip Code | 56560-3444 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992162440 | Amy Davis | Physical Therapy Assistant | 1405 7th St S, Moorhead, MN 56560-3444 | 2016-01-27 |
| 1093172074 | Sarah Nordick | Occupational Therapist | 1405 7th St S, Moorhead, MN 56560-3444 | 2016-01-21 |
| 1992161541 | Bonnie Linda Teske | Occupational Therapy Assistant | 1405 7th St S, Moorhead, MN 56560-3444 | 2016-01-12 |
| 1821454786 | Debra Remark | Physical Therapist | 1405 7th St S, Moorhead, MN 56560-3444 | 2016-01-07 |
| 1144686072 | Janice Mueller | Occupational Therapist | 1405 7th St S, Moorhead, MN 56560-3444 | 2016-01-07 |
| 1639535651 | Sharon Rae Arnold | Physical Therapist | 1405 7th St S, Moorhead, MN 56560-3444 | 2016-01-06 |
| 1720348014 | Sarah Nordin | Occupational Therapist | 1405 7th St S, Moorhead, MN 56560-3444 | 2012-05-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386298859 | Anna Mckay Fox | Pharmacist | 4000 28th Avenue S, Moorhead, MN 56560 | 2019-08-01 |
| 1972019727 | Michael Wayne Hilliard | Specialist/Technologist | 649 17th St S, Moorhead, MN 56560 | 2017-12-15 |
| 1508217183 | Kristen Johnson | Nurse Practitioner | 801 Belsly Boulevard, Moorhead, MN 56560 | 2016-06-25 |
| 1861877052 | Midwest Mental Health Clinic | Nurse Practitioner | 819 30th Ave S Office 206 Suite B, Moorhead, MN 56560 | 2015-07-29 |
| 1083037709 | Drake Counseling Services, Inc. | Clinic/Center | 715 11th Street North, Suite 204, Moorhead, MN 56560 | 2014-01-31 |
| 1710310917 | Lamar Terrell Hill | Social Worker | 420 Center Ave Ste 102, Moorhead, MN 56560 | 2013-08-12 |
| 1982956140 | Lilac Homes Corporation | Assisted Living Facility | 2615 Parkview Dr, Moorhead, MN 56560 | 2012-10-11 |
| 1487918462 | Paige Joy Hanson | Massage Therapist | 805 14th St. So., Msum Wellness Center, Moorhead, MN 56560 | 2012-06-25 |
| 1972809408 | Cslm, LLC | Assisted Living Facility | 2401 South 11th Street, Moorhead, MN 56560 | 2011-02-01 |
| 1972814846 | Paul Michael Fluto | Pharmacist | 3000 Hwy 10 East, Mooehead, MN 56560 | 2010-06-25 |
| Find all providers in zip 56560 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982956140 | Lilac Homes Corporation | Assisted Living Facility | 2615 Parkview Dr, Moorhead, MN 56560 | 2012-10-11 |
| 1972809408 | Cslm, LLC | Assisted Living Facility | 2401 South 11th Street, Moorhead, MN 56560 | 2011-02-01 |
| 1841529765 | Ashby Holdings LLC | Assisted Living Facility | 3101 S Frontage Rd, Moorhead, MN 56560-2545 | 2009-12-24 |
| 1073749040 | Arbor Park Village, LLC | Assisted Living Facility | 520 28th St N, Moorhead, MN 56560-2441 | 2009-06-04 |
| 1588878086 | Ecumen | Assisted Living Facility | 512 3rd Ave S, Moorhead, MN 56560-2703 | 2007-05-10 |
| 1609956069 | 4 Seasons At Moorhead LLC | Assisted Living Facility | 2921 6th Ave N, Moorhead, MN 56560-2594 | 2006-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871193417 | Midwest Group Home | Assisted Living Facility | 4232 5th St Ne, Columbia Heights, MN 55421-2860 | 2020-10-30 |
| 1710587696 | Friesen & Friesen, Inc | Assisted Living Facility | 1971 Ne 1st Avenue, Grand Rapids, MN 55744 | 2020-10-29 |
| 1750980603 | Estherra Care LLC | Assisted Living Facility | 1120 Morgan Ave N, Minneapolis, MN 55411-3805 | 2020-10-21 |
| 1679189682 | Daniel Care Homes LLC | Assisted Living Facility | 6809 Perry Ave N, Brooklyn Center, MN 55429-1611 | 2020-09-16 |
| 1326651779 | Secured Health and Homecare Inc | Assisted Living Facility | 4519 104th Ave N, Brooklyn Park, MN 55443-1030 | 2020-08-26 |
| 1811509870 | Aurora Assisted Living LLC | Assisted Living Facility | 115 Magnolia Ave W, Saint Paul, MN 55117-4916 | 2020-08-20 |
| 1003427477 | In My Father's House | Assisted Living Facility | 3096 Snelling Ave N, Roseville, MN 55113-1659 | 2020-08-11 |
| 1710595863 | Eden Prairie Senior Living | Assisted Living Facility | 8480 Franlo Rd, Eden Prairie, MN 55344-2938 | 2020-07-15 |
| 1447868468 | Brightstar Services LLC | Assisted Living Facility | 1821 University Ave W Ste 120, Saint Paul, MN 55104-2811 | 2020-07-15 |
| 1235757667 | Roers Senior Living Buffalo LLC | Assisted Living Facility | 150 Division Street East, Buffalo, MN 55313 | 2020-07-13 |
| Find all providers with the same taxonomy | ||||
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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.