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

Q: What is Good Shepherd Lutheran Home Of Sauk Rapids, Mn, Inc.'s specialty?

The primary specialty registered for this NPI is Alzheimer Center (Dementia Center) with taxonomy code 311500000X.

Active since December 13, 2006CLIA 24D0406058 · Waiver

307 11TH ST N, SAUK RAPIDS, MN 56379(320) 252-6525(320) 259-3463 Get Directions Write a Review

NPPES record last updated: August 13, 2021. Verified against the NPPES registry weekly; last sync: September 27, 2026.

Record update history: Aug 13, 2021, Aug 22, 2020 (2 updates tracked since 2020).

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About Good Shepherd Memory Loss Cottages NPPES

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

GOOD SHEPHERD MEMORY LOSS COTTAGES (NPI 1396807962) is a healthcare organization registered as an alzheimer center (dementia center) in Sauk Rapids, Minnesota and active in the NPI registry since December 2006. The organization holds a CLIA Waiver certificate valid through August 31, 2028 and lists Michael Stordahl, Administrator Ceo, as its authorized official.

NPPES Registry Identity

NPI1396807962

Entity TypeOrganization

Primary Taxonomy311500000X

Legal Business NameGOOD SHEPHERD LUTHERAN HOME OF SAUK RAPIDS, MN, INC.

Location Address307 11TH ST NSauk Rapids, MN 56379-2184

Mailing Address1115 4th Ave NSauk Rapids, MN 56379-2201 · (320) 252-6525 · Fax (320) 259-3463

Phone(320) 252-6525

Fax(320) 259-3463

Organization SubpartNo

Authorized OfficialMichael StordahlAdministrator Ceo · (320) 252-6525

Enumeration DateDecember 13, 2006

Last NPPES UpdateAugust 13, 20212 updates tracked since enumeration

NPPES CertifiedAugust 13, 2021

✔ NPI 1396807962 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyAlzheimer Center (Dementia Center)Nursing & Custodial Care Facilities

Taxonomy Code311500000X

License✔ Licensed in MN · 333736

Definition

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.

Also ListedAssisted Living FacilityTaxonomy 310400000X

307 11TH ST N, Sauk Rapids, MN 56379

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Other Names 2

Doing Business AsGood Shepherd Memory Loss Cottages

Doing Business AsGood Shepherd Cottages

Other Identifiers 1

Medicaid1396807962MN

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 24D0406058

Good Shepherd Lutheran Home · Sauk Rapids, MN

Active · expires Aug 31, 2028

CLIA Number24D0406058

Laboratory TypeSkilled Nursing Facility/Nursing Facility

Certificate Effective DateSeptember 1, 2026

Certificate Expiration DateAugust 31, 2028

Laboratory DirectorJackie Barber

Laboratory Phone(320) 252-6525

Laboratory LocationGood Shepherd Lutheran Home1115 N 4th Ave, Sauk Rapids, MN 56379

CLIA data matches this NPI record on: Name 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 Good Shepherd Lutheran Home Of Sauk Rapids, Mn, Inc.'s NPI number?

The NPI number for Good Shepherd Lutheran Home Of Sauk Rapids, Mn, Inc. is 1396807962. It was assigned to this organization in the NPPES registry on December 13, 2006. The provider is doing business as Good Shepherd Memory Loss Cottages and Good Shepherd Cottages.

Where is Good Shepherd Lutheran Home Of Sauk Rapids, Mn, Inc. located?

Good Shepherd Lutheran Home Of Sauk Rapids, Mn, Inc. is located at 307 11th St N, Sauk Rapids, MN 56379. The listed phone number is (320) 252-6525.

What is Good Shepherd Lutheran Home Of Sauk Rapids, Mn, Inc.'s specialty?

The primary specialty registered for this NPI is Alzheimer Center (Dementia Center) with taxonomy code 311500000X.

Does Good Shepherd Lutheran Home Of Sauk Rapids, Mn, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D0406058) is associated with this NPI, valid through August 31, 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 Good Shepherd Lutheran Home Of Sauk Rapids, Mn, Inc. was last updated on August 13, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.