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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

COUNTRY MEADOWS OF MILACA, INC.
NPI 1124103569
Assisted Living Facility in Milaca, MN

Active since October 26, 2006
740 2ND ST SE, MILACA, MN 56353(320) 983-2185(320) 983-2190 Get Directions Write a Review

NPPES record last updated: July 23, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 23, 2026, Nov 21, 2025, Oct 24, 2023 and 1 more (4 updates tracked since 2020).

About Country Meadows Of Milaca, Inc. NPPES

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

COUNTRY MEADOWS OF MILACA, INC. (NPI 1124103569) is a healthcare organization registered as an assisted living facility in Milaca, Minnesota and active in the NPI registry since October 2006. The organization lists Seelochani Stadtherr, Avp, Revenue Cycle Management, as its authorized official.

NPPES Registry Identity

NPI1124103569
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameCOUNTRY MEADOWS OF MILACA, INC.
Location Address740 2ND ST SEMilaca, MN 56353-4653
Mailing Address7171 Ohms LnEdina, MN 55439-2142 · (952) 855-5041
Phone(320) 983-2185
Fax(320) 983-2190
Organization SubpartNo
Authorized OfficialSeelochani StadtherrAvp, Revenue Cycle Management · (952) 855-5041
Enumeration DateOctober 26, 2006
Last NPPES UpdateJuly 23, 20264 updates tracked since enumeration
NPPES CertifiedJuly 23, 2026
✔ NPI 1124103569 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License✔ Licensed in MN · 332815
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.

740 2ND ST SE, Milaca, MN 56353
Open in Google Maps ↗

Other Identifiers 1

Medicaid896487100MN

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 24D1056897

Country Meadows Of Milaca Inc · Milaca, MN
Expired · Jul 27, 2026
CLIA Number24D1056897
Laboratory TypeHome Health Agency
Certificate Effective DateJuly 28, 2024
Certificate Expiration DateJuly 27, 2026
Laboratory DirectorJeune Johnson
Laboratory Phone(320) 983-6386
Laboratory LocationCountry Meadows Of Milaca Inc740 2nd Street SE, Milaca, MN 56353
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 Country Meadows Of Milaca, Inc.'s NPI number?

The NPI number for Country Meadows Of Milaca, Inc. is 1124103569. It was assigned to this organization in the NPPES registry on October 26, 2006.

Where is Country Meadows Of Milaca, Inc. located?

Country Meadows Of Milaca, Inc. is located at 740 2nd St SE, Milaca, MN 56353. The listed phone number is (320) 983-2185.

What is Country Meadows Of Milaca, Inc.'s specialty?

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

When was this NPI record last updated?

The NPPES record for Country Meadows Of Milaca, Inc. was last updated on July 23, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.