CHESTNUT GROVE
NPI 1386879476
Alzheimer Center (Dementia Center) in Virginia, MN
- Organization
- Alzheimer Center (Dementia Center)
- CLIA Number: 24D2231265
- CLIA Cert. Type: Assisted Living Facility
- CLIA Exp. Date: 08-01-2027
About CHESTNUT GROVE
This page provides the complete NPI Profile along with additional information for Chestnut Grove, a provider established in Virginia, Minnesota operating as a Alzheimer Center (dementia Center). The healthcare provider is registered in the NPI registry with number 1386879476 assigned on May 2009. The practitioner's primary taxonomy code is 311500000X with license number 1022171-1AFC (MN). The provider is registered as an organization and their NPI record was last updated 17 years ago. The provider's is doing business as Chestnut Grove. The authorized official of this NPI record is Mr. Randy P. Schroetter (Executive Director)
- NPI
- 1386879476 Verify this NPI
- Provider Legal Name
- RANGE DEVELOPMENT COMPANY
- Other Organization Name
- CHESTNUT GROVE
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 1204 CHESTNUT ST W VIRGINIA, MN 55792
- Location Phone
- (218) 749-6846
- Location Fax
- (218) 749-6846
- Mailing Address
- 2229 3RD AVE. E P.O. BOX 786 HIBBING, MN 55746
- Mailing Phone
- (218) 263-4157
- Mailing Fax
- (218) 263-8534
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-19-2009
- Last Update Date
- 05-20-2009
- Code Navigator
Location Map
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
Alzheimer Center (Dementia Center)
- Taxonomy Code
- 311500000X
- Type
- Nursing & Custodial Care Facilities
- License No.
- 1022171-1AFC
- License State
- MN
- Taxonomy Description
- A freestanding facility or special care unit of a long term care facility focusing on patient care of individuals diagnosed with dementia or Alzheimer's Disease or their related diseases. Six elements of the facility/unit set it apart from other (the rest of the) facilities(y): Admission of residents with dementia (including those with Alzheimer's disease); Staff who are specially selected, trained, and supervised; Activities that are specifically designed for the cognitively impaired; A marketing of a special care unit in brochures; A high level of family involvement; and A physical environment designed to keep residents safe and segregated from other populations.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 311500000X | Nursing & Custodial Care Facilities | Alzheimer Center (Dementia Center) | 1022172-1AFC (MN) |
| 2 | 311500000X | Nursing & Custodial Care Facilities | Alzheimer Center (Dementia Center) | 1010513-1AFC (MN) |
| 3 | 311500000X | Nursing & Custodial Care Facilities | Alzheimer Center (Dementia Center) | 1010514-1AFC (MN) |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 24D2231265
- Facility Type
- Assisted Living Facility
- Certificate Effective Date
- August 02, 2025
- Certificate Expiration Date
- August 01, 2027
- Laboratory Director
- AMANDA KLOPP
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Chestnut Grove to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1386879476, enumerated as an "organization" on May 19, 2009.
The provider is located at 1204 CHESTNUT ST W VIRGINIA, MN 55792 and the phone number is (218) 749-6846.
Alzheimer Center (Dementia Center) with taxonomy code 311500000X.
