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SAINT THERESE OF CORCORAN, LLC
NPI 1750126397
Assisted Living Facility in Corcoran, MN

Active since June 26, 2024CLIA Certified · 3 labs
19800 79TH PLACE, CORCORAN, MN 55340(763) 567-4700 Get Directions Write a Review

NPPES record last updated: June 26, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Saint Therese Of Corcoran, Llc NPPES

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

SAINT THERESE OF CORCORAN, LLC (NPI 1750126397) is a healthcare organization registered as an assisted living facility in Corcoran, Minnesota and active in the NPI registry since June 2024. The organization holds 3 active CLIA laboratory certificates and lists Cal M Shelangoski, Chief Financial Officer, as its authorized official.

NPPES Registry Identity

NPI1750126397
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameSAINT THERESE OF CORCORAN, LLC
Location Address19800 79TH PLACECorcoran, MN 55340
Mailing Address1660 Highway 100 S Ste 103Saint Louis Park, MN 55416-1599 · (952) 283-2204 · Fax (952) 224-0128
Phone(763) 567-4700
Organization SubpartNo
Authorized OfficialCal M ShelangoskiChief Financial Officer · (563) 554-7606
Enumeration DateJune 26, 2024
NPPES CertifiedJune 18, 2024
✔ NPI 1750126397 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
Definition
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.
19800 79TH PLACE, Corcoran, MN 55340
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CLIA Laboratory Certificates CMS CLIA 3

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 24D2312934

Saint Therese Of Corcoran-Homecare Services · Corcoran, MN
Active · expires Oct 21, 2026
CLIA Number24D2312934
Laboratory TypeAssisted Living Facility
Certificate Effective DateOctober 22, 2024
Certificate Expiration DateOctober 21, 2026
Laboratory DirectorJessica C. Fudali
Laboratory Phone(763) 567-4700
Laboratory LocationSaint Therese Of Corcoran-Homecare Services19800 79th Place, Corcoran, MN 55340
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 24D2312929

Saint Therese Of Corcoran-Assisted Living · Corcoran, MN
Active · expires Oct 21, 2026
CLIA Number24D2312929
Laboratory TypeAssisted Living Facility
Certificate Effective DateOctober 22, 2024
Certificate Expiration DateOctober 21, 2026
Laboratory DirectorJessica C. Fudali
Laboratory Phone(763) 567-4700
Laboratory LocationSaint Therese Of Corcoran-Assisted Living19810 79th Place, Corcoran, MN 55340
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 24D2312938

Saint Therese Of Corcoran-Memory Care Al · Corcoran, MN
Active · expires Oct 21, 2026
CLIA Number24D2312938
Laboratory TypeAssisted Living Facility
Certificate Effective DateOctober 22, 2024
Certificate Expiration DateOctober 21, 2026
Laboratory DirectorJessica C. Fudali
Laboratory Phone(763) 567-4700
Laboratory LocationSaint Therese Of Corcoran-Memory Care Al19820 79th Place, Corcoran, MN 55340
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 Saint Therese Of Corcoran, LLC's NPI number?

The NPI number for Saint Therese Of Corcoran, LLC is 1750126397. It was assigned to this organization in the NPPES registry on June 26, 2024.

Where is Saint Therese Of Corcoran, LLC located?

Saint Therese Of Corcoran, LLC is located at 19800 79th Place, Corcoran, MN 55340. The listed phone number is (763) 567-4700.

What is Saint Therese Of Corcoran, LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Saint Therese Of Corcoran, LLC hold CLIA laboratory certificates?

Yes. 3 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.

When was this NPI record last updated?

The NPPES record for Saint Therese Of Corcoran, LLC was last updated on June 26, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.