SOUTHSIDE CARE CENTER
NPI 1063565398
Intermediate Care Facility, Mental Illness in Minneapolis, MN
Overall Rating: 1 out of 5 stars
NPI Status: Active since January 19, 2007
Contact Information
2644 ALDRICH AVE S
MINNEAPOLIS, MN
ZIP 55408
Phone: (612) 819-5606
- Organization
- Intermediate Care Facility, Mental Illne...
- CLIA Number: 24D0886050
- CLIA Cert. Type: Skilled Nursing Facility/Nursing Facility
- CLIA Exp. Date: 05-11-2026
About SOUTHSIDE CARE CENTER
This page provides the complete NPI Profile along with additional information for Southside Care Center, a provider established in Minneapolis, Minnesota operating as a Intermediate Care Facility, Mental Illness. The healthcare provider is registered in the NPI registry with number 1063565398 assigned on January 2007. The practitioner's primary taxonomy code is 310500000X with license number 334535 (MN). The provider is registered as an organization and their NPI record was last updated 6 years ago. The authorized official of this NPI record is Mr. Richard Alan Kronfeld (Manager, Mis)
- NPI
- 1063565398
- Provider Name
- SOUTHSIDE CARE CENTER
- Entity Type
- Organization
- Location Address
- 2644 ALDRICH AVE S MINNEAPOLIS, MN 55408
- Location Phone
- (612) 819-5606
- Mailing Address
- 4221 BEVERLY AVE MINNEAPOLIS, MN 55422
- Mailing Phone
- (612) 819-5606
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 01-19-2007
- Last Update Date
- 08-22-2020
- Code Navigator
According to the Nursing Home Compare program data, Southside Care Center has a much below average overall quality rating based on the provider's performance on three separate measures including: health inspections, staffing, and quality of resident care information. These quality measures, combined in a star rating of 1 out of 5 stars provide a snapshot of this nursing home quality.
Location Map
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
Intermediate Care Facility, Mental Illness
- Taxonomy Code
- 310500000X
- Type
- Nursing & Custodial Care Facilities
- License No.
- 334535
- License State
- MN
- Taxonomy Description
- A nursing facility that provides an intermediate level of nursing care to individuals whose functional abilities are significantly compromise by mental illness.
Nursing Home Quality Information
The Centers for Medicare and Medicaid Services publishes the Nursing Home Compare star rating data to provide consumers an easy way to compare nursing home's quality of care.
| Overall Quality Rating | Not Available |
| The overall star rating is based on a nursing homes's performance on health inspections, staffing and quality measures. | |
| Health Inspection Rating | Not Available |
| The health inspection star rating is based on a nursing home’s weighted score from the most recent health inspections. | |
| Quality Measures Rating | - 4 out of 5 stars - Above Average |
| The quality measures star rating is based on data from a select set of clinical measures. | |
| Long-Stay Quality Measures Rating | - 4 out of 5 stars - Above Average |
| The long-stay quality of care rating is based on the quality of care delivered to long-term residents only. | |
| Short-Stay Quality Measures Rating | Not Available |
| The short-stay quality of care rating is based on the quality of care delivered to temporary residents only. *Not enough data available to calculate a star rating. | |
| Staffing Rating | - 4 out of 5 stars - Above Average |
| The staffing rating is based on the star rating based on the nursing home’s staffing hours for Registered Nurses (RNs), Licensed Practice Nurses (LPNs), Licensed Vocational Nurses (LVNs) and Nurse aides. | |
| Nurse Aide Staffing Hours | 0 hours per resident per day |
| Nurse aide hours per resident per day. Higher number of hours are better. | |
| RN Staffing Hours | 1.36 hours per resident per day |
| Resgistered nurse hours per resident per day. Higher number of hours are better. | |
| Ownership Type | For profit - Corporation |
| Is the facility private for profit, not-for profit or publicly owned. | |
| Number of Certified Beds | 17 beds |
| Number of beds in the nursing home that have been approved by the federal government to participate in the Medicare or Medicaid programs. | |
| Residents per Day | 11 residents |
| Average number of residents living in the facility per day. | |
| Automatic Sprinkler Systems | Yes |
| Does the facility have automatic sprinkler systems in all required areas? | |
| Facility Reported Incidents | 2 incidents |
| Number of facility-reported incidents in the past 3 years. A lower number is better. | |
| Substantiated Complaints | 0 complaints |
| Number of substantiated complaints in the past 3 years. A lower number is better. | |
| Citations from Inspections | citations after infection control inspection |
| Number of citations from infection control inspections in the past 3 years. A lower number is better. | |
| Total Number of Penalties | 0 penalties from a serious health, fire safety or long-term unresolved citation |
| The Medicare program may impose penalties on a facilty when there's serious health or fire safety citations or if the facility fails to correct a citation for a long period of time. | |
| Number of Fines | 0 fines |
| Toal number of fines in the last 3 years. A penalty can be a fine against the facility or denied payments from Medicare. | |
| Amount of Fines | $0.00 |
| Total monetary amount of fine imposed on the facility in the last 3 years. | |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 24D0886050
- Facility Type
- Skilled Nursing Facility/Nursing Facility
- Certificate Effective Date
- May 12, 2024
- Certificate Expiration Date
- May 11, 2026
- Laboratory Director
- EMMANUEL TANDOH
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Southside Care Center to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1063565398, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 52. The final step is to find the difference between that total and the next multiple of ten (60 - 52 = 8).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 52 is 60. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1063565398, enumerated as an "organization" on January 19, 2007.
The provider is located at 2644 ALDRICH AVE S MINNEAPOLIS, MN 55408 and the phone number is (612) 819-5606.
Intermediate Care Facility, Mental Illness with taxonomy code 310500000X.
