WENDIGO PINES ASSISTED LIVING
NPI 1205913613
Assisted Living Facility in Grand Rapids, MN

NPI Status: Active since November 01, 2006

Contact Information

20371 WENDIGO PARK RD
GRAND RAPIDS, MN
ZIP 55744
Phone: (218) 326-6900
Fax: (218) 326-6900

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  • Organization
  • Assisted Living Facility

About WENDIGO PINES ASSISTED LIVING

This page provides the complete NPI Profile along with additional information for Wendigo Pines Assisted Living, a provider established in Grand Rapids, Minnesota operating as a Assisted Living Facility. The healthcare provider is registered in the NPI registry with number 1205913613 assigned on November 2006. The practitioner's primary taxonomy code is 310400000X with license number 333801 (MN). The provider is registered as an organization and their NPI record was last updated 5 years ago. The authorized official of this NPI record is Raisa Povlovna Kotula Rn (Rn Owner)

NPI
1205913613
Provider Name
WENDIGO PINES ASSISTED LIVING
Entity Type
Organization
Location Address
20371 WENDIGO PARK RD GRAND RAPIDS, MN 55744
Location Phone
(218) 326-6900
Location Fax
(218) 326-6900
Mailing Address
20371 WENDIGO PARK RD GRAND RAPIDS, MN 55744
Mailing Phone
(218) 326-6900
Mailing Fax
(218) 326-6900
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
11-01-2006
Last Update Date
08-22-2020
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Assisted Living Facility

Taxonomy Code
310400000X
Type
Nursing & Custodial Care Facilities
License No.
333801
License State
MN
Taxonomy Description
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.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

RAISA POVLOVNA KOTULA RN

Authorized Official Title
RN OWNER
Authorized Official Phone
(218) 326-6900

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1205913613
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2205181662
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 2 + 0 + 5 + 1 + 8 + 1 + 6 + 6 + 2 + 24 = 57
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 57 = 33

The NPI number 1205913613 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1306185681NEW JOURNEY RESIDENCE, LTD
Organization
Assisted Living Facility20371 WENDIGO PARK RD
GRAND RAPIDS, MN 55744
(218) 326-6900

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1205913613, enumerated in the NPI registry as an "organization" on November 01, 2006

The provider is located at 20371 Wendigo Park Rd Grand Rapids, Mn 55744 and the phone number is (218) 326-6900

This medical organization specializes in Assisted Living Facility with taxonomy code 310400000X

This NPI record was last updated on November 01, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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