1. Home
  2. Directory
  3. Minnesota
  4. Bagley
  5. Intermediate Care Facility Mentally Retarded
  6. NPI Profile

PINE RIDGE RESIDENCE INC
NPI 1811192271
Intermediate Care Facility, Intellectual Disabilities in Bagley, MN

Active since June 18, 2007
503 HALLAN AVE, BAGLEY, MN 56621(218) 694-6716(218) 694-3799 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Pine Ridge Residence Inc NPPES

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

PINE RIDGE RESIDENCE INC (NPI 1811192271) is a healthcare organization registered as an intermediate care facility, intellectual disabilities in Bagley, Minnesota and active in the NPI registry since June 2007. The organization lists Donald L Blooflat, Administrator, as its authorized official.

NPPES Registry Identity

NPI1811192271
Entity TypeOrganization
Primary Taxonomy315P00000X
Legal Business NamePINE RIDGE RESIDENCE INC
Location Address503 HALLAN AVEBagley, MN 56621-0029
Mailing AddressPo Box 29Bagley, MN 56621-0029 · (218) 694-6716 · Fax (218) 694-3799
Phone(218) 694-6716
Fax(218) 694-3799
Organization SubpartNo
Authorized OfficialDonald L BlooflatAdministrator · (218) 694-6716
Enumeration DateJune 18, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1811192271 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyIntermediate Care Facility, Intellectual DisabilitiesNursing & Custodial Care Facilities
Taxonomy Code315P00000X
Definition
An intermediate care facility providing services for individuals with intellectual disabilities.
503 HALLAN AVE, Bagley, MN 56621
Open in Google Maps ↗

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 Pine Ridge Residence Inc's NPI number?

The NPI number for Pine Ridge Residence Inc is 1811192271. It was assigned to this organization in the NPPES registry on June 18, 2007.

Where is Pine Ridge Residence Inc located?

Pine Ridge Residence Inc is located at 503 Hallan Ave, Bagley, MN 56621. The listed phone number is (218) 694-6716.

What is Pine Ridge Residence Inc's specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

When was this NPI record last updated?

The NPPES record for Pine Ridge Residence Inc was last updated on August 22, 2020. 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.