Country Manor Campus LLC · Assisted Living Facility

520 1st St Ne, Sartell, MN 56377-1274

Overview

Country Manor Campus LLC is a Assisted Living Facility (organization) practicing in Sartell, Minnesota. The National Provider Identifier (NPI) is #1912896135, which was assigned on July 1, 2025, and the registration record was last updated on July 1, 2025. The practitioner's main practice location is at 520 1st St Ne, Sartell, MN 56377-1274; the contact telephone number is 3202531920. The primary taxonomy of Country Manor Campus LLC is Assisted Living Facility (310400000X). The authorized official for Country Manor Campus LLC is Kevin G. Harguth (Cfo).

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.

Provider Information

NPI 1912896135
Entity Type Organization
Organization Name COUNTRY MANOR CAMPUS LLC
Provider Name COUNTRY MANOR CAMPUS LLC
Practice Address 520 1st St Ne
Sartell
MN 56377-1274
Practice Telephone 3202531920
Mailing Address 520 1st St Ne
Sartell
MN 56377-1274
Mailing Telephone 3202531920
Certification Date 2025-07-01
Enumeration Date 2025-07-01
Last Update Date 2025-07-01
Is Organization Subpart Y
Parent Organization Legal Business Name COUNTRY MANOR CAMPUS LLC

Authorized Official Information

Official Name KEVIN G. HARGUTH
Official Title CFO
Telephone 3202588983

Taxonomy and Licenses

PrimaryCodeClassificationSpecializationTaxonomy GroupLicense NumberLicense State
N251E00000XHome Health
Y310400000XAssisted Living Facility

Other Provider Names

Other Organization NameType
The Country VillaDoing Business As Name

Secondary Practice Locations

AddressTelephoneFax
504 1st St NE, Sartell, MN 5637712733202531920

Taxonomy Information

Primary Taxonomy

Code 310400000X
Taxonomy Assisted Living Facility
Classification Assisted Living Facility
Grouping Nursing & Custodial Care Facilities
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.
Notes: [7/1/2003: new]

Other Taxonomy

Code 251E00000X
Taxonomy Home Health Agency
Classification Home Health
Grouping Agencies
Definition: A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.
Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added]

Providers with the same taxonomy

Provider NameAddressTaxonomyEnumeration Date
O.S.J. Family Place 4113 Seybold Ave, Orlando, FL 32808-2110Assisted Living Facility2026-04-09
Columbia Cottage - Collegeville, LLC 901 E Main St, Collegeville, PA 19426-2403Assisted Living Facility2026-04-09
Columbia Cottage - Wyomissing Hills, LLC 3121 State Hill Rd, Wyomissing, PA 19610-1001Assisted Living Facility2026-04-09
Second Story LLC 1013 W River Rd, Champlin, MN 55316-2002Assisted Living Facility2026-04-09
Comfort Living 7154 Mckee Rd, Madison, WI 53719-5240Assisted Living Facility2026-04-08
Columbia Cottage - Hanover, LLC 2288 Grandview Rd, Hanover, PA 17331-9344Assisted Living Facility2026-04-09
Varna Assisted Living 6848 Varna Ave, Van Nuys, CA 91405-4355Assisted Living Facility2026-04-10
Burbank Pathway Villa 1029 N Buena Vista St, Burbank, CA 91505-2320Assisted Living Facility2026-04-09
Be Happy Be Home 3 Inc. 17631 Los Alimos St, Granada Hills, CA 91344-4619Assisted Living Facility2026-04-09
Trinitys Care LLC 1049 Pavone St, Benton Harbor, MI 49022-5344Assisted Living Facility2026-04-11
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Location Information

Street Address 520 1ST ST NE
City SARTELL
State MN
Zip Code 56377-1274
Country US

Providers in the same zip code

Provider NameAddressTaxonomyEnumeration Date
Integracare Ltd 2251 Connecticut Ave S Ste 2100, Sartell, MN 56377-2486Physical Therapist2006-12-19
Troy Michael Zenzen 604 W Sartell St, Sartell, MN 56377-1900Rehabilitation Counselor2007-02-22
Sleep Therapy 2157 Troop Dr Ste 100, Sartell, MN 56377Prosthetic/Orthotic Supplier2011-03-18
Ecumen Sbc Sartell Properties, LLC 960 19th St S, Sartell, MN 56377-2597Assisted Living Facility2026-02-11
Daniel Turnblom 1901 Connecticut Ave S, Sartell, MN 56377-2554Physician Assistant2013-11-05
Walgreen Co 1100 2nd St S, Sartell, MN 56377-2152Durable Medical Equipment & Medical Supplies2006-07-29
Kulmis Transportation LLC 830 Roberts Rd Apt 208, Sartell, MN 56377-0277Non-emergency Medical Transport (VAN)2023-11-14
Sartell Pediatrics, P.A. 111 2nd St S, Sartell, MN 56377-1917Pediatrics Physician2012-03-28
Small Holdings Pa 161 19th St S Ste 106, Sartell, MN 56377-2555Dermatology Physician2024-10-28
Olivia Elizabeth Hoeschen 1901 Connecticut Ave S, Sartell, MN 56377-2554Physical Therapist2022-03-17
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Dataset Information

This dataset includes over five million health care providers who are assigned National Provider Identifier (NPI) in the National Plan and Provider Enumeration System (NPPES), developed by the Centers for Medicare & Medicaid Services (CMS). Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under Health Insurance Portability and Accountability Act (HIPAA). Each provider is registered with the NPI, full name, status, address, taxonomy, other identifiers, etc.

Subject Transparency and Disclosure
Jurisdiction Federal
Data Provider National Plan and Provider Enumeration System (NPPES), by the Centers for Medicare & Medicaid Services (CMS)
Source download.cms.gov

Dataset Details

The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers and all health plans and health care clearinghouses, who must use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number).

All health care providers who are HIPAA-covered entities, whether individuals or organizations, must get an NPI. A HIPAA-covered entity is a health care provider that conducts certain transactions in electronic form, or a health care clearinghouse, or a health plan (including commercial plans, Medicare, and Medicaid).

Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider Enumeration System (NPPES) to assign unique identifiers to health care providers. The National Provider Indentifier (NPI) has been the standard identifier for all HIPAA-covered entities (health care providers) since May 23, 2007. Small health plans were required to obtain and use an NPI by May 23, 2008.

This dataset includes over five million health care providers (individuals and organizations) who are assigned NPI. The provider data elements are disclosed to the public by the Centers for Medicare & Medicaid Services (CMS) under the Freedom of Information Act (FOIA), as listed in the NPPES Data Dissemination Notice (CMS-6060-N). The NPI final rules define the following elements which required to be disclosed as determined by Department of Health & Human Services (HHS): NPI, Entity Type, Provider Name, Credential, Business Mailing Address, Business Location Address, Healthcare Provider Taxonomy Code, Other Provider Identifier, Provider Enumeration Date, NPI Deactivation Date, Provider License Number, Authorized Official Name and Contact Information.