GRAND VILLAGE
NPI 1184662793
Skilled Nursing Facility in Grand Rapids, MN
About Grand Village NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GRAND VILLAGE (NPI 1184662793) is a healthcare organization registered as a skilled nursing facility in Grand Rapids, Minnesota and active in the NPI registry since June 2006. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Jacob Goering, Executive Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
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 24D0700197
Grand Village · Grand Rapids, MNNursing Home Quality Ratings CMS Care Compare
Quality ratings, staffing and inspection history for Grand Village (CMS certification number 245368), from CMS Care Compare.
Grand Village
Nursing home · Grand Rapids, MNCMS Star Ratings
Staffing & Turnover
Inspections & Enforcement
Other Providers at the Same Location NPPES 6
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Itasca Nursing Home's NPI number?
The NPI number for Itasca Nursing Home is 1184662793. It was assigned to this organization in the NPPES registry on June 4, 2006. The provider is doing business as Grand Village.
Where is Itasca Nursing Home located?
Itasca Nursing Home is located at 923 Hale Lake Pointe, Grand Rapids, MN 55744. The listed phone number is (218) 326-0543.
What is Itasca Nursing Home's specialty?
The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.
Does Itasca Nursing Home hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 24D0700197) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
Is Itasca Nursing Home a Medicare-certified nursing home?
Yes. Grand Village is a Medicare-certified nursing home with 114 certified beds.
What quality rating does Itasca Nursing Home have?
CMS rates Grand Village 3 out of 5 stars overall on Care Compare. The full measure detail is in the Nursing Home Quality Ratings section above.
When was this NPI record last updated?
The NPPES record for Itasca Nursing Home 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 6 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.