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PROVIDENCE VILLA
NPI 1003305723
Assisted Living Facility in Sebeka, MN

Active since May 08, 2018CLIA 24D2139156 · Waiver
200 MINNESOTA AVE E, SEBEKA, MN 56477(218) 837-9162(218) 837-6861 Get Directions Write a Review

NPPES record last updated: January 16, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 16, 2019, May 8, 2018 (2 updates tracked since 2018).

About Providence Villa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROVIDENCE VILLA (NPI 1003305723) is a healthcare organization registered as an assisted living facility in Sebeka, Minnesota and active in the NPI registry since May 2018. The organization holds a CLIA Waiver certificate valid through October 30, 2027 and lists Andrew Charles Huhta, Owner, as its authorized official.

NPPES Registry Identity

NPI1003305723
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NamePROVIDENCE VILLA
Location Address200 MINNESOTA AVE ESebeka, MN 56477-5002
Mailing Address200 Minnesota Ave ESebeka, MN 56477-5002 · (218) 837-9162 · Fax (218) 837-6861
Phone(218) 837-9162
Fax(218) 837-6861
Organization SubpartNo
Authorized OfficialAndrew Charles HuhtaOwner · (218) 837-9162
Enumeration DateMay 8, 2018
Last NPPES UpdateJanuary 16, 20192 updates tracked since enumeration
✔ NPI 1003305723 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
Definition
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.
200 MINNESOTA AVE E, Sebeka, MN 56477
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Other Names 1

Doing Business AsProvidence Villa

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 24D2139156

Providence Villa · Sebeka, MN
Active · expires Oct 30, 2027
CLIA Number24D2139156
Laboratory TypeAssisted Living Facility
Certificate Effective DateOctober 31, 2025
Certificate Expiration DateOctober 30, 2027
Laboratory DirectorAndrew C. Huhta
Laboratory Phone(218) 837-5497
Laboratory LocationProvidence Villa200 Minnesota Ave East, Sebeka, MN 56477
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Providence Villa's NPI number?

The NPI number for Providence Villa is 1003305723. It was assigned to this organization in the NPPES registry on May 8, 2018.

Where is Providence Villa located?

Providence Villa is located at 200 Minnesota Ave E, Sebeka, MN 56477. The listed phone number is (218) 837-9162.

What is Providence Villa's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Providence Villa hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D2139156) is associated with this NPI, valid through October 30, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Providence Villa was last updated on January 16, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.