PETERSON FAMILY LIVING
NPI 1205050333
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Elk River, MN

NPI Status: Active since April 12, 2007

Contact Information

12400 RIDGEWOOD DR NW
ELK RIVER, MN
ZIP 55330
Phone: (763) 441-8034
Fax: (763) 441-8034

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About PETERSON FAMILY LIVING

This page provides the complete NPI Profile along with additional information for Peterson Family Living, a provider established in Elk River, Minnesota operating as a Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities. The healthcare provider is registered in the NPI registry with number 1205050333 assigned on April 2007. The practitioner's primary taxonomy code is 320900000X with license number 1027767 1 WS (MN). The provider is registered as an organization and their NPI record was last updated 6 years ago. The authorized official of this NPI record is Mrs. Kathie R Peterson (Residential Coordinator)

NPI
1205050333
Provider Name
PETERSON FAMILY LIVING
Entity Type
Organization
Location Address
12400 RIDGEWOOD DR NW ELK RIVER, MN 55330
Location Phone
(763) 441-8034
Location Fax
(763) 441-8034
Mailing Address
12400 RIDGEWOOD DR NW ELK RIVER, MN 55330
Mailing Phone
(763) 441-8034
Mailing Fax
(763) 441-8034
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
04-12-2007
Last Update Date
08-22-2020
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

Taxonomy Code
320900000X
Type
Residential Treatment Facilities
License No.
1027767 1 WS
License State
MN
Taxonomy Description
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MRS. KATHIE R PETERSON

Authorized Official Title
RESIDENTIAL COORDINATOR
Authorized Official Phone
(763) 441-8034

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1205050333, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 47. The final step is to find the difference between that total and the next multiple of ten (50 - 47 = 3).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
0
Doubled → 0
Pos 4
5
Unchanged
Pos 5
0
Doubled → 0
Pos 6
5
Unchanged
Pos 7
0
Doubled → 0
Pos 8
3
Unchanged
Pos 9
3
Doubled → 6
Check
3
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 0 → 0 0 → 0 0 → 0 3 → 6

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 0 + 5 + 0 + 5 + 0 + 3 + 6 + 24 = 47

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 47 is 50. The difference is the calculated check digit.

50 - 47 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1205050333.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1205050333, enumerated as an "organization" on April 12, 2007.

The provider is located at 12400 RIDGEWOOD DR NW ELK RIVER, MN 55330 and the phone number is (763) 441-8034.

Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320900000X.