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Sholom Home West Inc

Skilled Nursing Facility in St Louis Park, MN · enumerated 2005 · authorized official Douglas Wyckoff, Controller.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1770560005

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Registry record

Entity type Organization (Type 2)
Legal business name Sholom Home West Inc
Practice address 3620 Phillips Pkwy, St Louis Park, MN, 55426
Fax (952) 935-2701
Enumeration date Dec 28, 2005
Last updated in NPPES May 14, 2019

Taxonomy & classification

314000000X Skilled Nursing Facility Nursing & Custodial Care Facilities · License 328688 (MN) Primary

Authorized official

Name Douglas Wyckoff
Title Controller

Other identifiers

Identifier Type State Issuer
23377 Other MN HEALTH PARTNERS
4553SH Other MN BLUE CROSS OF MINNESOTA
971216005 Other MN METRA HEALTH
151743100 Medicaid MN -
NH0048 Other MN UCARE
000320420 Other - HIGHMARK
30425 Medicaid ND -
7100366 Other MN EVERCARE
7122633 Other MN MEDICA

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2019-05-14. Verify at npiregistry.cms.hhs.gov.
Where is Sholom Home West Inc located?
The practice location on file with NPPES is in St Louis Park, MN.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2019-05-14.