BETHANY ON THE LAKE LLC
NPI 1609380500
Skilled Nursing Facility in Alexandria, MN

Active since November 30, 2017CLIA Certified · 2 labs
5/5
Overall Rating
1020 LARK ST, ALEXANDRIA, MN 56308(320) 762-1567 Get Directions Write a Review

NPPES record last updated: October 16, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 16, 2019, Nov 30, 2017 (2 updates tracked since 2017).

About Bethany On The Lake Llc NPPES

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

BETHANY ON THE LAKE LLC (NPI 1609380500) is a healthcare organization registered as a skilled nursing facility in Alexandria, Minnesota and active in the NPI registry since November 2017. The organization holds 2 active CLIA laboratory certificates and lists Joshua Legum, Ceo, as its authorized official.

NPPES Registry Identity

NPI1609380500
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameBETHANY ON THE LAKE LLC
Location Address1020 LARK STAlexandria, MN 56308-2219
Mailing Address638 Southbend AveMankato, MN 56001-2168 · (507) 697-5674
Organization SubpartNo
Authorized OfficialJoshua LegumCeo · (507) 625-8741
Enumeration DateNovember 30, 2017
Last NPPES UpdateOctober 16, 20192 updates tracked since enumeration
NPI 1609380500 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
1020 LARK ST, Alexandria, MN 56308

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA 2

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 24D0405854

Bethany On The Lake · Alexandria, MN
Active · expires Aug 31, 2026
CLIA Number24D0405854
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorJessica Dezeeuw
Laboratory Phone(320) 762-1567
Laboratory LocationBethany On The Lake1020 Lark St, Alexandria, MN 56308
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 24D2057355

Bethany On The Lake Assisted Living · Alexandria, MN
Active · expires Nov 17, 2027
CLIA Number24D2057355
Laboratory TypeAssisted Living Facility
Certificate Effective DateNovember 18, 2025
Certificate Expiration DateNovember 17, 2027
Laboratory DirectorBrittany Schmidt
Laboratory Phone(320) 763-2180
Laboratory LocationBethany On The Lake Assisted Living1020 Lark St, Alexandria, MN 56308
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Nursing Home Quality Ratings CMS Care Compare

Quality ratings, staffing and inspection history for Bethany On The Lake LLC (CMS certification number 245434), from CMS Care Compare.

Bethany On The Lake LLC

Nursing home · Alexandria, MN
5/5 CMS Overall Rating
OwnershipFor profit - Corporation
CMS Certification Number245434
Certified Beds83 beds69 residents per day on average
Medicare & Medicaid Participant SinceFebruary 1, 1987
Resident & Family CouncilResident and family councils
Automatic sprinkler system

CMS Star Ratings

Quality Measures
Based on a select set of clinical quality measures.
4/5
Long-Stay Quality
Quality of care delivered to long-term residents.
2/5
Short-Stay Quality
Quality of care delivered to short-term and rehabilitation residents.
5/5
Staffing
Based on nursing staff hours relative to resident needs.
5/5
Weighted Health Inspection Score
Lower scores are better; the score summarizes deficiencies found on recent inspections.
17.33
Ratings are assigned by CMS on a one-to-five star scale; five is the highest. Categories without a current CMS rating are not shown.

Staffing & Turnover

Total Nurse Staffing
nurse aide 1.85 · LPN 0.9 · RN 1.05
3.81 hrs per resident per day
Weekend Nurse Staffing
3.26 hrs per resident per day
Physical Therapist Staffing
0.08 hrs per resident per day
Nursing Staff Turnover
Share of nursing staff who left the facility within the past year.
27.1%
Registered Nurse Turnover
17.4%
Administrators Who Have Left
In the past year.
0
Higher staffing hours generally allow more direct care time per resident.

Inspections & Enforcement

Facility-Reported Incidents
0
Substantiated Complaints
0
Fines
2 totaling $1,625.00
Medicare Payment Denials
0
Total Penalties
2
Counts come from CMS inspections and complaint investigations over approximately the past three years. CMS Care Compare data as of October 1, 2024.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Skilled Nursing Facility
1020 LARK ST
ALEXANDRIA, MN 56308
Physical Therapist (Geriatrics)
1020 LARK ST
ALEXANDRIA, MN 56308
Home Health
1020 LARK ST
ALEXANDRIA, MN 56308
Assisted Living Facility
1020 LARK ST
ALEXANDRIA, MN 56308
Occupational Therapy Assistant
1020 LARK ST
ALEXANDRIA, MN 56308
Occupational Therapist
1020 LARK ST
ALEXANDRIA, MN 56308
Occupational Therapist
1020 LARK ST
ALEXANDRIA, MN 56308

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 Bethany On The Lake LLC's NPI number?

The NPI number for Bethany On The Lake LLC is 1609380500. It was assigned to this organization in the NPPES registry on November 30, 2017.

Where is Bethany On The Lake LLC located?

Bethany On The Lake LLC is located at 1020 Lark St, Alexandria, MN 56308. The listed phone number is (320) 762-1567.

What is Bethany On The Lake LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Bethany On The Lake LLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

Is Bethany On The Lake LLC a Medicare-certified nursing home?

Yes. Bethany On The Lake LLC is a Medicare-certified nursing home with 83 certified beds.

What quality rating does Bethany On The Lake LLC have?

CMS rates Bethany On The Lake LLC 5 out of 5 stars overall on Care Compare. The full measure detail is in the Nursing Home Quality Ratings section above.

What insurance does Bethany On The Lake LLC accept?

Health plans from HealthPartners list Bethany On The Lake LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Bethany On The Lake LLC was last updated on October 16, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.