FAIR OAKS LODGE
NPI 1043210925
Skilled Nursing Facility in Wadena, MN

Active since July 21, 2005CLIA 24D0406240 · Waiver
201 SHADY LANE DR, WADENA, MN 56482(218) 631-1391 Get Directions Write a Review

NPPES record last updated: June 25, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Fair Oaks Lodge NPPES

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

FAIR OAKS LODGE (NPI 1043210925) is a healthcare organization registered as a skilled nursing facility in Wadena, Minnesota and active in the NPI registry since July 2005. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Eric R. Lunde, President, as its authorized official.

NPPES Registry Identity

NPI1043210925
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameLSS OF WADENA, LLC
Location Address201 SHADY LANE DRWadena, MN 56482-3093
Mailing Address201 Shady Lane DrWadena, MN 56482-3093 · (218) 631-1391
Organization SubpartNo
Authorized OfficialEric R. LundePresident · (218) 631-1163
Enumeration DateJuly 21, 2005
Last NPPES UpdateJune 25, 2013
NPI 1043210925 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in MN · 357827
Definition

(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

Also ListedHome HealthTaxonomy 251E00000X · License 358367 (MN)
201 SHADY LANE DR, Wadena, MN 56482

Other Names 1

Doing Business AsFair Oaks Lodge

Other Identifiers 3

Other9510SHBcbs
Medicare OSCAR/certification1043210925MN
Medicaid719475700MN

Accepted Insurance

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 24D0406240

Fair Oaks Lodge · Wadena, MN
Active · expires Aug 31, 2026
CLIA Number24D0406240
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorTara Staber
Laboratory Phone(218) 631-1391
Laboratory LocationFair Oaks Lodge201 Shady Lane Drive, Wadena, MN 56482
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Hospice Care, Community Based
201 SHADY LANE DR
WADENA, MN 56482
Skilled Nursing Facility
201 SHADY LANE DR, 201 SHADY LANE DRIVE
WADENA, MN 56482
Physical Therapist
201 SHADY LANE DR
WADENA, MN 56482
Psychiatric Hospital
201 SHADY LANE DR
WADENA, MN 56482
Physical Therapist
201 SHADY LANE DR
WADENA, MN 56482
Occupational Therapy Assistant
201 SHADY LANE DR
WADENA, MN 56482
Skilled Nursing Facility
201 SHADY LANE DR
WADENA, MN 56482

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 Lss Of Wadena, LLC's NPI number?

The NPI number for Lss Of Wadena, LLC is 1043210925. It was assigned to this organization in the NPPES registry on July 21, 2005. The provider is doing business as Fair Oaks Lodge.

Where is Lss Of Wadena, LLC located?

Lss Of Wadena, LLC is located at 201 Shady Lane Dr, Wadena, MN 56482. The listed phone number is (218) 631-1391.

What is Lss Of Wadena, LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Lss Of Wadena, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D0406240) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Lss Of Wadena, LLC accept?

Health plans from Medica list Lss Of Wadena, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lss Of Wadena, LLC was last updated on June 25, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.