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LUTHERAN SOCIAL SERVICE OF MINNESOTA
NPI 1114385085
Intermediate Care Facility, Intellectual Disabilities in Elk River, MN

Active since February 05, 2016CLIA 24D0702038 · Waiver
11754 191 1/2 AVE NW, ELK RIVER, MN 55330(651) 310-9451 Get Directions Write a Review

NPPES record last updated: February 24, 2017. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Feb 24, 2017, Feb 5, 2016 (2 updates tracked since 2016).

About Lutheran Social Service Of Minnesota NPPES

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

LUTHERAN SOCIAL SERVICE OF MINNESOTA (NPI 1114385085) is a healthcare organization registered as an intermediate care facility, intellectual disabilities in Elk River, Minnesota and active in the NPI registry since February 2016. The organization holds a CLIA Waiver certificate valid through January 25, 2027 and lists Brigid Peterson, Chief Compliance & Integration, as its authorized official.

NPPES Registry Identity

NPI1114385085
Entity TypeOrganization
Primary Taxonomy315P00000X
Legal Business NameLUTHERAN SOCIAL SERVICE OF MINNESOTA
Location Address11754 191 1/2 AVE NWElk River, MN 55330-1367
Mailing Address2485 Como AveSaint Paul, MN 55108-1445 · (800) 582-5260 · Fax (651) 969-2350
Phone(651) 310-9451
Organization SubpartNo
Authorized OfficialBrigid PetersonChief Compliance & Integration · (651) 310-9451
Enumeration DateFebruary 5, 2016
Last NPPES UpdateFebruary 24, 20172 updates tracked since enumeration
✔ NPI 1114385085 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyIntermediate Care Facility, Intellectual DisabilitiesNursing & Custodial Care Facilities
Taxonomy Code315P00000X
Definition

An intermediate care facility providing services for individuals with intellectual disabilities.

11754 191 1/2 AVE NW, Elk River, MN 55330
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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 24D0702038

Lutheran Social Service Of Minnesota · Saint Paul, MN
Active · expires Jan 25, 2027
CLIA Number24D0702038
Laboratory TypeIntermediate Care Facility For Mentally Retarded
Certificate Effective DateJanuary 26, 2025
Certificate Expiration DateJanuary 25, 2027
Laboratory DirectorJody Miller
Laboratory Phone(651) 310-9451
Laboratory LocationLutheran Social Service Of Minnesota2485 Como Ave, Saint Paul, MN 55108
CLIA data matches this NPI record on: Address Name Phone
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 Lutheran Social Service Of Minnesota's NPI number?

The NPI number for Lutheran Social Service Of Minnesota is 1114385085. It was assigned to this organization in the NPPES registry on February 5, 2016.

Where is Lutheran Social Service Of Minnesota located?

Lutheran Social Service Of Minnesota is located at 11754 191 1/2 Ave NW, Elk River, MN 55330. The listed phone number is (651) 310-9451.

What is Lutheran Social Service Of Minnesota's specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

Does Lutheran Social Service Of Minnesota hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D0702038) is associated with this NPI, valid through January 25, 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 Lutheran Social Service Of Minnesota was last updated on February 24, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.