HENRY HAGEN RESIDENCE
NPI 1194901751
Intermediate Care Facility, Intellectual Disabilities in Hastings, MN

Q: What is Henry Hagen Residence's NPI number?

The NPI number for Henry Hagen Residence is 1194901751. It was assigned to this organization in the NPPES registry on January 14, 2008.

Q: What is Henry Hagen Residence's specialty?

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

Active since January 14, 2008CLIA 24D2037417 · Waiver

19845 LILLEHEI AVE, HASTINGS, MN 55033(651) 437-9363(651) 437-9363 Get Directions Write a Review

NPPES record last updated: January 14, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Henry Hagen Residence NPPES

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

HENRY HAGEN RESIDENCE (NPI 1194901751) is a healthcare organization registered as an intermediate care facility, intellectual disabilities in Hastings, Minnesota and active in the NPI registry since January 2008. The organization holds a CLIA Waiver certificate valid through February 26, 2028 and lists Roger David Reynolds, Owner, as its authorized official.

NPPES Registry Identity

NPI1194901751

Entity TypeOrganization

Primary Taxonomy315P00000X

Legal Business NameHENRY HAGEN RESIDENCE

Location Address19845 LILLEHEI AVEHastings, MN 55033-9354

Mailing Address19845 Lillehei AveHastings, MN 55033-9354 · (651) 437-9363 · Fax (651) 437-9363

Phone(651) 437-9363

Fax(651) 437-9363

Organization SubpartNo

Authorized OfficialRoger David ReynoldsOwner · (651) 603-8881

Enumeration DateJanuary 14, 2008

✔ NPI 1194901751 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

License✔ Licensed in MN · 01091

Definition

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

19845 LILLEHEI AVE, Hastings, MN 55033

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Other Identifiers 1

Medicare OSCAR/certification24G128MN

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 24D2037417

Henry Hagen Hagen Residence · Hastings, MN

Active · expires Feb 26, 2028

CLIA Number24D2037417

Laboratory TypeIntermediate Care Facility For Mentally Retarded

Certificate Effective DateFebruary 27, 2026

Certificate Expiration DateFebruary 26, 2028

Laboratory DirectorJolynn Michalski

Laboratory Phone(651) 437-9363

Laboratory LocationHenry Hagen Hagen Residence19545 Lillehei Drive, Hastings, MN 55033

CLIA data matches this NPI record on: 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 Henry Hagen Residence's NPI number?

The NPI number for Henry Hagen Residence is 1194901751. It was assigned to this organization in the NPPES registry on January 14, 2008.

Where is Henry Hagen Residence located?

Henry Hagen Residence is located at 19845 Lillehei Ave, Hastings, MN 55033. The listed phone number is (651) 437-9363.

What is Henry Hagen Residence's specialty?

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

Does Henry Hagen Residence hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D2037417) is associated with this NPI, valid through February 26, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Henry Hagen Residence was last updated on January 14, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.