ESTATES AT ST LOUIS PARK LLC (NPI# 1689112153) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689112153 |
| Entity Type | Organization |
| Organization Name | ESTATES AT ST LOUIS PARK LLC |
| Practice Address |
3201 Virginia Ave S St Louis Park MN 55426-3624 |
| Mailing Address |
638 Southbend Ave Mankato MN 56001-2168 |
| Practice Telephone | 9529350333 |
| Enumeration Date | 2017-02-06 |
| Last Update Date | 2017-02-06 |
| Authorized Official Name | JOSHUA LEGUM (CEO) |
| Authorized Official Telephone | 5976258741 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| Street Address |
3201 VIRGINIA AVE S |
| City | ST LOUIS PARK |
| State | MN |
| Zip Code | 55426-3624 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932150380 | Ggnsc Minneapolis St. Louis Park LLC | Skilled Nursing Facility | 3201 Virginia Ave S, St Louis Park, MN 55426-3624 | 2006-05-12 |
| 1669073003 | Leika May Schmidt | Licensed Practical Nurse | 3201 Virginia Ave S, St Louis Park, MN 55426-3624 | 2020-11-03 |
| 1457975294 | Sarah Kearney | Physical Therapist | 3201 Virginia Ave S, St Louis Park, MN 55426-3624 | 2020-06-06 |
| 1679193049 | Lauren Graham | Physical Therapist | 3201 Virginia Ave S, St Louis Park, MN 55426-3624 | 2020-04-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821657545 | Big Brain Concussion Recovery & Chiropractic Pa | Chiropractor | 3313 Republic Ave., St. Louis Park, MN 55426 | 2019-06-06 |
| 1912485095 | Daniel Raies | Optometrist | 8900 Minnesota 7, St Louis Park, MN 55426 | 2018-08-01 |
| 1649756040 | Wayside House, Inc. | Clinic/Center | 1349 Jersey Ave S, St. Louis Park, MN 55426 | 2018-07-18 |
| 1104302884 | Superior Caregivers, LLC | In Home Supportive Care | 1319 Lancaster Ave., St. Louis Park, MN 55426 | 2018-07-16 |
| 1396234266 | Caitlin Kwiatkowski | Behavior Technician | 7010 Mn-7, St.louis Park, MN 55426 | 2018-05-07 |
| 1497244313 | Kelly Ann Clancey | Behavior Technician | 7010 Highway 2, Saint Louis Park, MN 55426 | 2018-05-07 |
| 1770072696 | Ashleigh Hakala | Behavior Technician | 7010 Highway 7 St. Louis Park Mn 55426, St. Louis Park, MN 55426 | 2018-05-07 |
| 1689181521 | Glenda Miles | Registered Nurse | 7316 Cedar Lake Road, Apt 8, St Louis Park, MN 55426 | 2017-12-31 |
| 1174041875 | Kristen Webb | Physician Assistant | 3931 Louisiana Ave S, Suite E-500, St. Louis Park, MN 55426 | 2017-09-01 |
| 1447775549 | Belinda Sue Bliss | Marriage & Family Therapist | 3301 Decatur Lane, Saint Louis Park, MN 55426 | 2017-08-09 |
| Find all providers in zip 55426 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194156034 | Sheron Home Health Care, LLC | Skilled Nursing Facility | 2480 Highway 100 S, Apt 132, St Louis Park, MN 55416-1762 | 2013-12-03 |
| 1184798712 | Extendicare Homes, Inc. | Skilled Nursing Facility | 4415 W 36 1/2 St, St Louis Park, MN 55416-4854 | 2006-11-17 |
| 1578635082 | Extendicare Homes, Inc. | Skilled Nursing Facility | 7900 W 28th St, St Louis Park, MN 55426-3011 | 2006-11-14 |
| 1932150380 | Ggnsc Minneapolis St. Louis Park LLC | Skilled Nursing Facility | 3201 Virginia Ave S, St Louis Park, MN 55426-3624 | 2006-05-12 |
| 1770560005 | Sholom Home West Inc | Skilled Nursing Facility | 3620 Phillips Pkwy, St Louis Park, MN 55426-3700 | 2005-12-28 |
| 1336133990 | Aviv Health Care, Inc. | Skilled Nursing Facility | 7500 W 22nd St, St Louis Park, MN 55426-2602 | 2005-09-09 |
| 1417466970 | St. Louis Park Opco, LLC | Skilled Nursing Facility | 7900 W 28th St, St Louis Park, MN 55426-3011 | 2017-09-27 |
| 1215446786 | St. Louis Park Opco II, LLC | Skilled Nursing Facility | 4415 W 36 1/2 St, St Louis Park, MN 55416-4854 | 2017-09-27 |
| 1679965909 | Fmg West 28th Street Minnesota LLC | Skilled Nursing Facility | 7900 W 28th St, St Louis Park, MN 55426-3011 | 2015-02-24 |
| 1861884199 | Fmg West 36 1/2 Street Minnesota LLC | Skilled Nursing Facility | 4415 W 36 1/2 St, St Louis Park, MN 55416-4854 | 2015-02-24 |
| Find all providers in ST LOUIS PARK | ||||
| City | ST LOUIS PARK |
| Zip Code | 55426 |
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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.