KI SENIOR LIVING OF PARK RAPIDS, LLC (NPI# 1659866630) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659866630 |
| Entity Type | Organization |
| Organization Name | KI SENIOR LIVING OF PARK RAPIDS, LLC |
| Other Organization Name | CRYSTAL BROOK SENIOR LIVING |
| Practice Address |
1006 Crocus Hill St E Park Rapids MN 56470-5419 |
| Mailing Address |
420 12th Ave E Alexandria MN 56308-2612 |
| Practice Telephone | 2186993605 |
| Mailing Telephone | 3207636653 |
| Mailing Fax Number | 3207637548 |
| Enumeration Date | 2018-06-22 |
| Last Update Date | 2018-06-22 |
| Authorized Official Name | MRS. MARNIE MARIE GUGISBERG (CFO) |
| Authorized Official Telephone | 3207631164 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| CRYSTAL BROOK SENIOR LIVING | Doing Business As Name - Organization |
| Street Address |
1006 CROCUS HILL ST E |
| City | PARK RAPIDS |
| State | MN |
| Zip Code | 56470-5419 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720693542 | Joshua M Still | Physical Therapist | 829 Lake Ave S, Suite B, Park Rapids, MN 56470 | 2020-09-09 |
| 1730731464 | St Marys Regional Health Center | Clinic/Center | 1103 1st St E, Park Rapids, MN 56470 | 2019-07-12 |
| 1174091904 | Amanda Marie Slaikeu | Physical Therapist | 705 Pleasant Avenue South, Park Rapids, MN 56470 | 2018-11-09 |
| 1184965261 | Hubbard County Sheriff's Office | Secured Medical Transport (VAN) | 203 Court Ave, Park Rapids, MN 56470 | 2013-03-14 |
| 1134481666 | Michelle Lynn Rice | Physical Therapy Assistant | 600 Pleasant Ave, St. Joseph's Area Health Services, Park Rapids, MN 56470 | 2012-06-11 |
| 1790047355 | Amanda Dawn Runyan | Physical Therapist | 600 Pleasant Ave., St. Joseph's Area Health Services, Park Rapids, MN 56470 | 2012-06-11 |
| 1629330279 | Lois G. Mcclatchie | Physical Therapist | 600 Pleasant Avenue, St. Joseph's Area Health Services, Park Rapids, MN 56470 | 2012-06-11 |
| 1376832576 | Ryan G Strasburg | Nurse Anesthetist, Certified Registered | 506 Henrietta Ave N, Park Rapids, MN 56470 | 2011-03-29 |
| 1891966479 | Jay C Jorgenson Dds Pa | Dentist | 406 Pleasant Ave, Park Rapids, MN 56470 | 2008-03-21 |
| 1629250063 | Five Star Living of Park Rapids, LLC | Assisted Living Facility | 911 Crocus Hill Street, Birch Park Suites, Park Rapids, MN 56470 | 2007-11-28 |
| Find all providers in zip 56470 | ||||
| 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 |
|---|---|---|---|---|
| 1972900025 | Fcsl Park Rapids, LLC | Assisted Living Facility | 909 Crocus Hill St E, Park Rapids, MN 56470-2527 | 2014-12-04 |
| 1144493669 | Care-age Country Home | Assisted Living Facility | 18846 Eagle Bend Rd, Park Rapids, MN 56470-2073 | 2008-04-04 |
| 1629250063 | Five Star Living of Park Rapids, LLC | Assisted Living Facility | 911 Crocus Hill Street, Birch Park Suites, Park Rapids, MN 56470 | 2007-11-28 |
| 1659553170 | Five Star Living of Park Rapids, LLC | Assisted Living Facility | 909 Crocus Hill St, Evergreen Suites, Park Rapids, MN 56470 | 2007-11-27 |
| 1902204001 | Fcsl Park Rapids, LLC | Assisted Living Facility | 911 Crocus Hill Street, Park Rapids, MN 56470 | 2014-12-05 |
| 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 | PARK RAPIDS |
| Zip Code | 56470 |
Please comment or provide details below to improve the information on KI SENIOR LIVING OF PARK RAPIDS, LLC.
| 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.