GOOD SHEPHERD MEMORY LOSS COTTAGES
NPI 1396807962
Alzheimer Center (Dementia Center) in Sauk Rapids, MN

NPI Status: Active since December 13, 2006

Contact Information

307 11TH ST N
SAUK RAPIDS, MN
ZIP 56379
Phone: (320) 252-6525
Fax: (320) 259-3463

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  • Organization
  • Alzheimer Center (Dementia Center)
  • CLIA Number: 24D0406058
  • CLIA Cert. Type: Skilled Nursing Facility/Nursing Facility
  • CLIA Exp. Date: 08-31-2026

About GOOD SHEPHERD MEMORY LOSS COTTAGES

This page provides the complete NPI Profile along with additional information for Good Shepherd Memory Loss Cottages, a provider established in Sauk Rapids, Minnesota operating as a Alzheimer Center (dementia Center). The healthcare provider is registered in the NPI registry with number 1396807962 assigned on December 2006. The practitioner's primary taxonomy code is 311500000X with license number 333736 (MN). The provider is registered as an organization and their NPI record was last updated 5 years ago. The provider's is doing business as Good Shepherd Memory Loss Cottages. The authorized official of this NPI record is Mr. Michael Stordahl (Administrator Ceo)

NPI
1396807962
Provider Legal Name
GOOD SHEPHERD LUTHERAN HOME OF SAUK RAPIDS, MN, INC.
Other Organization Name
GOOD SHEPHERD MEMORY LOSS COTTAGES
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
307 11TH ST N SAUK RAPIDS, MN 56379
Location Phone
(320) 252-6525
Location Fax
(320) 259-3463
Mailing Address
1115 4TH AVE N SAUK RAPIDS, MN 56379
Mailing Phone
(320) 252-6525
Mailing Fax
(320) 259-3463
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
12-13-2006
Last Update Date
08-13-2021
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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

Alzheimer Center (Dementia Center)

Taxonomy Code
311500000X
Type
Nursing & Custodial Care Facilities
License No.
333736
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)
1310400000XNursing & Custodial Care Facilities

Assisted Living Facility

 

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

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

MR. MICHAEL STORDAHL

Authorized Official Title
ADMINISTRATOR CEO
Authorized Official Phone
(320) 252-6525

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
1396807962MEDICAID (05)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
24D0406058
Facility Type
Skilled Nursing Facility/Nursing Facility
Certificate Effective Date
September 01, 2024
Certificate Expiration Date
August 31, 2026
Laboratory Director
JACKIE BARBER
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Good Shepherd Memory Loss Cottages 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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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 1396807962, we treat the final digit (2) 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 68. The final step is to find the difference between that total and the next multiple of ten (70 - 68 = 2).

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
3
Unchanged
Pos 3
9
Doubled → 18 → 1 + 8
Pos 4
6
Unchanged
Pos 5
8
Doubled → 16 → 1 + 6
Pos 6
0
Unchanged
Pos 7
7
Doubled → 14 → 1 + 4
Pos 8
9
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
2
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 9 → 18 → 9 8 → 16 → 7 7 → 14 → 5 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

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

2 + 3 + 1 + 8 + 6 + 1 + 6 + 0 + 1 + 4 + 9 + 1 + 2 + 24 = 68

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

The next multiple of ten after 68 is 70. The difference is the calculated check digit.

70 - 68 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1396807962.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1396807962, enumerated as an "organization" on December 13, 2006.

The provider is located at 307 11TH ST N SAUK RAPIDS, MN 56379 and the phone number is (320) 252-6525.

Alzheimer Center (Dementia Center) with taxonomy code 311500000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.