PETERSON COLONIAL HOMES, INC.
NPI 1104037985
Assisted Living Facility - Assisted Living, Mental Illness in Brookston, MN

Q: What is Peterson Colonial Homes, Inc.'s NPI number?

The NPI number for Peterson Colonial Homes, Inc. is 1104037985. It was assigned to this organization in the NPPES registry on May 24, 2007.

Q: What is Peterson Colonial Homes, Inc.'s specialty?

The primary specialty registered for this NPI is Assisted Living Facility, specializing in Assisted Living, Mental Illness, with taxonomy code 3104A0625X.

Active since May 24, 2007CLIA Certified · 2 labs

4723 NYGAARD ROAD, BROOKSTON, MN 55711(218) 878-0642(218) 878-2978 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Peterson Colonial Homes, Inc. NPPES

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

PETERSON COLONIAL HOMES, INC. (NPI 1104037985) is a healthcare organization registered as an assisted living, mental illness in Brookston, Minnesota and active in the NPI registry since May 2007. The organization holds 2 active CLIA laboratory certificates and lists Duane Melvin Schraw, Administrator, as its authorized official.

NPPES Registry Identity

NPI1104037985

Entity TypeOrganization

Primary Taxonomy3104A0625X

Legal Business NamePETERSON COLONIAL HOMES, INC.

Location Address4723 NYGAARD ROADBrookston, MN 55711-0350

Mailing AddressPo Box 350Brookston, MN 55711-0350 · (218) 878-0642 · Fax (218) 878-2978

Phone(218) 878-0642

Fax(218) 878-2978

Organization SubpartNo

Authorized OfficialDuane Melvin SchrawAdministrator · (218) 878-0642

Enumeration DateMay 24, 2007

Last NPPES UpdateAugust 22, 2020

✔ NPI 1104037985 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living Facility · Assisted Living, Mental IllnessNursing & Custodial Care Facilities

Taxonomy Code3104A0625X

License✔ Licensed in MN · 0021

Definition

A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies.

4723 NYGAARD ROAD, Brookston, MN 55711

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CLIA Laboratory Certificates CMS CLIA 2

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 24D2150784

Peterson Colonial Homes, Inc · Brookston, MN

Active · expires Jul 2, 2028

CLIA Number24D2150784

Laboratory TypeAssisted Living Facility

Certificate Effective DateJuly 3, 2026

Certificate Expiration DateJuly 2, 2028

Laboratory DirectorBradley M. Eckel

Laboratory Phone(218) 878-0642

Laboratory LocationPeterson Colonial Homes, Inc4723 Nygaard Rd, Brookston, MN 55711

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 24D2150797

Peterson Colonial Homes, Inc · Brookston, MN

Active · expires Jul 2, 2028

CLIA Number24D2150797

Laboratory TypeAssisted Living Facility

Certificate Effective DateJuly 3, 2026

Certificate Expiration DateJuly 2, 2028

Laboratory DirectorBradley M. Eckel

Laboratory Phone(218) 453-5646

Laboratory LocationPeterson Colonial Homes, Inc4866 Hwy 31 N, Brookston, MN 55711

CLIA data matches this NPI record on: 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 Peterson Colonial Homes, Inc.'s NPI number?

The NPI number for Peterson Colonial Homes, Inc. is 1104037985. It was assigned to this organization in the NPPES registry on May 24, 2007.

Where is Peterson Colonial Homes, Inc. located?

Peterson Colonial Homes, Inc. is located at 4723 Nygaard Road, Brookston, MN 55711. The listed phone number is (218) 878-0642.

What is Peterson Colonial Homes, Inc.'s specialty?

The primary specialty registered for this NPI is Assisted Living Facility, specializing in Assisted Living, Mental Illness, with taxonomy code 3104A0625X.

Does Peterson Colonial Homes, Inc. hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Peterson Colonial Homes, Inc. was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.