CORNERSTONE ASSISTED LIVING OF PLYMOUTH, INC. (NPI# 1518955277) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518955277 |
| Entity Type | Organization |
| Organization Name | CORNERSTONE ASSISTED LIVING OF PLYMOUTH, INC. |
| Practice Address |
3750 Lawndale Ln N Plymouth MN 55446-2967 |
| Practice Telephone | 7635500333 |
| Practice Fax Number | 7633901888 |
| Mailing Telephone | 7635500333 |
| Mailing Fax Number | 7633901888 |
| Enumeration Date | 2005-10-07 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | PAUL MICKELSON (CORPORATE A/R MANAGER) |
| Authorized Official Telephone | 9522594485 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | 329138 | MN | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | MINNEOSTA STATE LICENSE | 329138 | 01 |
| Street Address |
3750 LAWNDALE LN N |
| City | PLYMOUTH |
| State | MN |
| Zip Code | 55446-2967 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114552379 | Molly M Mahoney | Pharmacist | 4110 Juneau Lane N, Plymouth, MN 55446 | 2020-03-09 |
| 1073064804 | Owen Payne Kusick | Student in an Organized Health Care Education/Training Program | 16717 49th Pl N, Plymouth, MN 55446 | 2016-10-17 |
| 1043696214 | Kari Shoemaker | Speech-Language Pathologist | 5855 Cheshire Parkway, Plymouth, MN 55446 | 2015-08-10 |
| 1902206899 | Kathleen E Steensma | Nurse Practitioner | 15700 37th Ave N. #110, Plymouth, MN 55446 | 2014-08-27 |
| 1851715163 | Group Health Plan Inc | Clinic/Center | 5000 Fernbrook Ln N, Plymouth, MN 55446 | 2014-02-06 |
| 1588903009 | Laura Davidson | Physician Assistant | 3365 Plymouth Blvd., Suite 110, Plymouth, MN 55446 | 2013-02-04 |
| 1366680688 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 6025 Shenandoah Ln N, Plymouth, MN 55446 | 2009-01-23 |
| 1205046646 | Merida A Miller | Obstetrics & Gynecology | 4155 Cty Rd 101 N, Plymouth, MN 55446 | 2007-05-23 |
| 1376684746 | West Metro Ophthalmology, Pa | Ophthalmology | 15655 37th Ave N Ste 200, Plymouth, MN 55446 | 2007-02-09 |
| 1952401390 | Grand St Paul Cvs LLC | Pharmacy | 4140 Rd 101 N, Plymouth, MN 55446 | 2006-09-25 |
| Find all providers in zip 55446 | ||||
| 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 |
|---|---|---|---|---|
| 1316580277 | Nsh Plymouth-southern LLC | Assisted Living Facility | 930 E Clifford St, Plymouth, WI 53073-2451 | 2019-10-23 |
| 1740823145 | Two Sisters Holdings LLC | Assisted Living Facility | 18040 Medina Rd, Plymouth, MN 55446-2920 | 2019-10-18 |
| 1912549486 | Szr Northville Assisted Living, LLC | Assisted Living Facility | 16100 N Haggerty Rd, Plymouth, MI 48170-4857 | 2019-10-16 |
| 1497262224 | Rajo Care Home Inc | Assisted Living Facility | 14015 Rockford Rd, Plymouth, MN 55447 | 2018-01-02 |
| 1174947824 | Plymouth Senior Housing, LLC | Assisted Living Facility | 16205 36th Ave N, Plymouth, MN 55446-3374 | 2014-02-14 |
| 1164863395 | Joseph's Chateau LLC | Assisted Living Facility | 12715 42nd Pl N, Plymouth, MN 55442-2350 | 2013-07-16 |
| 1477740215 | A&r Open Door Inc | Assisted Living Facility | 14215 46th Pl N, Plymouth, MN 55446-3494 | 2007-09-25 |
| 1326163056 | B-xii Plymouth LLC | Assisted Living Facility | 157 South St, Plymouth, MA 02360-7605 | 2007-03-20 |
| 1720144363 | Brookdale Senior Living Communities, Inc. | Assisted Living Facility | 15855 22nd Ave N, Plymouth, MN 55447-6452 | 2006-12-28 |
| 1952319899 | Miller's Health Systems, Inc. | Assisted Living Facility | 625 Oakhill Ave, Plymouth, IN 46563-3064 | 2006-08-04 |
| Find all providers in PLYMOUTH | ||||
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| 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.