EVENTIDE
NPI 1487705653
Assisted Living Facility in Moorhead, MN

NPI Status: Active since January 15, 2007

Contact Information

1405 7TH ST S
MOORHEAD, MN
ZIP 56560
Phone: (218) 233-7508
Fax: (218) 233-3602

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  • Organization
  • Assisted Living Facility
  • Accepts Insurance
  • CLIA Number: 24D0688820
  • CLIA Cert. Type: Skilled Nursing Facility/Nursing Facility
  • CLIA Exp. Date: 08-31-2026

About EVENTIDE

This page provides the complete NPI Profile along with additional information for Eventide, a provider established in Moorhead, Minnesota operating as a Assisted Living Facility. The healthcare provider is registered in the NPI registry with number 1487705653 assigned on January 2007. The practitioner's primary taxonomy code is 310400000X with license number 332819 (MN). The provider is registered as an organization and their NPI record was last updated one year ago. The authorized official of this NPI record is Mr. Wade E Stubson (Cfo)

NPI
1487705653
Provider Name
EVENTIDE
Entity Type
Organization
Location Address
1405 7TH ST S MOORHEAD, MN 56560
Location Phone
(218) 233-7508
Location Fax
(218) 233-3602
Mailing Address
1405 7TH ST S MOORHEAD, MN 56560
Mailing Phone
(218) 233-7508
Mailing Fax
(218) 233-3602
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
01-15-2007
Last Update Date
09-11-2025
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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

Assisted Living Facility

Taxonomy Code
310400000X
Type
Nursing & Custodial Care Facilities
License No.
332819
License State
MN
Taxonomy Description
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

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)
1314000000XNursing & Custodial Care Facilities

Skilled Nursing Facility

00072 (MN)

Insurance Plans Accepted

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

  • BlueCare Bronze HSA Eligible $50 PCP Copay ($5 Value Based Drug List) - PPO
  • BlueCare Gold $10 PCP Copay ($5 Value Based Drug List) - PPO
  • BlueCare Silver $20 PCP Copay ($5 Value Based Drug List) - PPO
  • BlueDirect Bronze 100 HSA Eligible ($8000 Deductible / $5 Preventive Drug List) - PPO
  • BlueDirect Gold 90 HSA Eligible ($2600 Deductible / $5 Preventive Drug List) - PPO
  • BlueDirect Silver 80 HSA Eligible ($3500 Deductible / $5 Preventive Drug List) - PPO
  • BlueEssential Catastrophic 100 HSA Eligible $10600 Deductible - PPO
  • BlueValue Bronze HSA Eligible $50 PCP Copay (Standardized plan) - PPO
  • BlueValue Gold $30 PCP Copay (Standardized plan) - PPO
  • BlueValue Silver $40 PCP Copay (Standardized plan) - PPO
  • DakotaBlue Altru Gold ($5 Value Based Drug List) - PPO
  • DakotaBlue Altru Silver ($5 Value Based Drug List) - PPO
  • DakotaBlue Trinity Gold ($5 Value Based Drug List) - PPO
  • DakotaBlue Trinity Silver ($5 Value Based Drug List) - PPO
  • Sanford Individual TRUE $1,750 - HMO
  • Sanford Individual TRUE $10,600 - HMO
  • Sanford Individual TRUE $3,500 - HMO
  • Sanford Individual TRUE $4,750 - HMO
  • Sanford Individual TRUE $6,500 - HMO
  • Sanford Individual TRUE $7,200 HSA Qualified - HMO
  • Sanford Individual TRUE Standardized $2,000 - HMO
  • Sanford Individual TRUE Standardized $6,000 - HMO
  • Sanford Individual TRUE Standardized $7,500 - HMO

*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. WADE E STUBSON

Authorized Official Title
CFO
Authorized Official Phone
(218) 291-2216

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
24D0688820
Facility Type
Skilled Nursing Facility/Nursing Facility
Certificate Effective Date
September 01, 2024
Certificate Expiration Date
August 31, 2026
Laboratory Director
BRITTNI BERG
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Eventide 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.

Reviews for EVENTIDE

There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.

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 1487705653, 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 57. The final step is to find the difference between that total and the next multiple of ten (60 - 57 = 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
4
Unchanged
Pos 3
8
Doubled → 16 → 1 + 6
Pos 4
7
Unchanged
Pos 5
7
Doubled → 14 → 1 + 4
Pos 6
0
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
6
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
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 8 → 16 → 7 7 → 14 → 5 5 → 10 → 1 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

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

2 + 4 + 1 + 6 + 7 + 1 + 4 + 0 + 1 + 0 + 6 + 1 + 0 + 24 = 57

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

The next multiple of ten after 57 is 60. The difference is the calculated check digit.

60 - 57 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1487705653.

Other Providers at the Same Location


The following 10 providers are registered at the same or a nearby location.

Occupational Therapist
1405 7TH ST S
MOORHEAD, MN 56560
Physical Therapist
1405 7TH ST S
MOORHEAD, MN 56560
Physical Therapist
1405 7TH ST S
MOORHEAD, MN 56560
Occupational Therapist
1405 7TH ST S
MOORHEAD, MN 56560
Occupational Therapy Assistant
1405 7TH ST S
MOORHEAD, MN 56560
Occupational Therapist
1405 7TH ST S
MOORHEAD, MN 56560
Physical Therapy Assistant
1405 7TH ST S
MOORHEAD, MN 56560
Occupational Therapist
1405 7TH ST S
MOORHEAD, MN 56560
Physical Therapist
1405 7TH ST S
MOORHEAD, MN 56560
Physical Therapist
1405 7TH ST S
MOORHEAD, MN 56560

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1487705653, enumerated as an "organization" on January 15, 2007.

The provider is located at 1405 7TH ST S MOORHEAD, MN 56560 and the phone number is (218) 233-7508.

Assisted Living Facility with taxonomy code 310400000X.

The provider might be accepting Accepts: Blue Cross Blue Shield of North Dakota and Sanford. Please consult your insurance carrier or call the provider to verify.