PHS/ COTTAGE GROVE (NPI# 1164848362) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164848362 |
| Entity Type | Organization |
| Organization Name | PHS/ COTTAGE GROVE |
| Other Organization Name | NORRIS SQUARE |
| Practice Address |
8200 Hadley Ave S Cottage Grove MN 55016-2697 |
| Practice Telephone | 6517696600 |
| Mailing Telephone | 6517696600 |
| Enumeration Date | 2014-03-12 |
| Last Update Date | 2014-03-12 |
| Authorized Official Name | MR. MARK MEYER (CFO) |
| Authorized Official Telephone | 6516316120 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | 357333 | MN | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | UMPI | A682632100 | 01 |
| Other Name | Type Code |
|---|---|
| Norris Square | Other Name - Individual/Organization |
| Street Address |
8200 HADLEY AVE S |
| City | COTTAGE GROVE |
| State | MN |
| Zip Code | 55016-2697 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073161519 | Kathleen Johnson | Technician | 7436 Hinton Park Ave South, Cottage Grove, MN 55016 | 2019-08-28 |
| 1710473434 | Cg Care Center, LLC. | Skilled Nursing Facility | 6993 80th Street South, Cottage Grove, MN 55016 | 2018-07-05 |
| 1235532771 | Lydia Sirucek | Nurse Practitioner | 8611 E Point Douglas Rd, Cottage Grove, MN 55016 | 2014-09-29 |
| 1366859746 | Home Care Service Providers Inc. | Home Health | 9635 Hamlet Ave, Cottage Grove, MN 55016 | 2014-07-17 |
| 1942622089 | Wal-mart Stores, Inc. | Technician/Technologist | 9300 East Point Douglas Rd S, Cottage Grove, MN 55016 | 2014-01-08 |
| 1255770962 | Southside At The Cottage Grove Site | Family Medicine | 8454 East Point Douglas Road, Cottage Grove, MN 55016 | 2013-06-17 |
| 1710222088 | Santori Chiropractic Center, LLC | Chiropractor | 7155 80th Street So, Cottage Grove, MN 55016 | 2012-11-28 |
| 1609151414 | Kenneth Nworah Okafor | Pharmacist | 7015 East Point Douglas Road, Cottage Grove, MN 55016 | 2011-10-13 |
| 1134432925 | Elizabeth Frances Rezek | Social Worker | 8813 Hale Ave S, Cottage Grove, MN 55016 | 2010-07-21 |
| 1841420882 | Mark Joseph Mangine | Physical Therapist | 6936 Pine Arbor Dr S Ste 150, Cottage Grove, MN 55016 | 2009-07-24 |
| Find all providers in zip 55016 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629626528 | Highland Homes and Services, Inc. | Assisted Living Facility | 8047 66th Street Ct S, Cottage Grove, MN 55016-1219 | 2019-09-03 |
| 1851547970 | Cottage Grove Wp, LLC | Assisted Living Facility | 6900 E Point Douglas Rd S, Cottage Grove, MN 55016-3009 | 2008-08-08 |
| 1932321072 | Middlefield Oaks | Assisted Living Facility | 1500 Village Drive, Cottage Grove, OR 97424 | 2007-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871193417 | Midwest Group Home | Assisted Living Facility | 4232 5th St Ne, Columbia Heights, MN 55421-2860 | 2020-10-30 |
| 1710587696 | Friesen & Friesen, Inc | Assisted Living Facility | 1971 Ne 1st Avenue, Grand Rapids, MN 55744 | 2020-10-29 |
| 1750980603 | Estherra Care LLC | Assisted Living Facility | 1120 Morgan Ave N, Minneapolis, MN 55411-3805 | 2020-10-21 |
| 1679189682 | Daniel Care Homes LLC | Assisted Living Facility | 6809 Perry Ave N, Brooklyn Center, MN 55429-1611 | 2020-09-16 |
| 1326651779 | Secured Health and Homecare Inc | Assisted Living Facility | 4519 104th Ave N, Brooklyn Park, MN 55443-1030 | 2020-08-26 |
| 1811509870 | Aurora Assisted Living LLC | Assisted Living Facility | 115 Magnolia Ave W, Saint Paul, MN 55117-4916 | 2020-08-20 |
| 1003427477 | In My Father's House | Assisted Living Facility | 3096 Snelling Ave N, Roseville, MN 55113-1659 | 2020-08-11 |
| 1710595863 | Eden Prairie Senior Living | Assisted Living Facility | 8480 Franlo Rd, Eden Prairie, MN 55344-2938 | 2020-07-15 |
| 1447868468 | Brightstar Services LLC | Assisted Living Facility | 1821 University Ave W Ste 120, Saint Paul, MN 55104-2811 | 2020-07-15 |
| 1235757667 | Roers Senior Living Buffalo LLC | Assisted Living Facility | 150 Division Street East, Buffalo, MN 55313 | 2020-07-13 |
| Find all providers with the same taxonomy | ||||
| City | COTTAGE GROVE |
| Zip Code | 55016 |
Please comment or provide details below to improve the information on PHS/ COTTAGE GROVE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.