MINNESOTA SENIOR LIVING LLC (NPI# 1720593353) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720593353 |
| Entity Type | Organization |
| Organization Name | MINNESOTA SENIOR LIVING LLC |
| Other Organization Name | MERIDIAN MANOR |
| Practice Address |
163 Wayzata Blvd W Wayzata MN 55391-1562 |
| Mailing Address |
915 118th Ave Se Ste 110 Bellevue WA 98005-3875 |
| Practice Telephone | 9524733200 |
| Mailing Telephone | 4255596301 |
| Enumeration Date | 2017-12-05 |
| Last Update Date | 2017-12-05 |
| Authorized Official Name | RENAE WITSCHEN (REGIONAL DIRECTOR OF OPERATIONS) |
| Authorized Official Telephone | 7632021702 |
| Is Organization Subpart | Y |
| Parent Organization Name | MINNESOTA SENIOR LIVING LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | 381390 | MN | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Meridian Manor | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780929257 | Minnesota Senior Living LLC | Assisted Living Facility | 3000 Douglas Dr N, Crystal, MN 55422-2452 | 2012-12-10 |
| 1356686836 | Minnesota Senior Living LLC | Assisted Living Facility | 6288 Louisiana Ct N, Brooklyn Park, MN 55428-2550 | 2012-12-10 |
| 1548505027 | Minnesota Senior Living LLC | Assisted Living Facility | 8500 Tessman Farm Rd N, Brooklyn Park, MN 55445-2297 | 2012-12-10 |
| Street Address |
163 WAYZATA BLVD W |
| City | WAYZATA |
| State | MN |
| Zip Code | 55391-1562 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740525229 | Meridian Manor Operatons LLC | Assisted Living Facility | 163 Wayzata Blvd W, Wayzata, MN 55391-1562 | 2012-12-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790386456 | Alexandra Lloyd Conroy | Counselor | 3227 Lake Shore Boulevard, Minnetonka, MN 55391 | 2020-11-07 |
| 1417579178 | Kate Anne Schroeder | Behavioral Analyst | 901 Twelve Oaks Center Drive Suite 934, Wayzata, MN 55391 | 2020-05-15 |
| 1467940478 | Tyler Michael Knutson | Chiropractor | 1421 E Wayzata Blvd, Wayzata, MN 55391 | 2018-04-25 |
| 1427552025 | Emma Nadler, L.L.C. | Counselor | 700 Twelve Oaks Center Dr. #263, Wayzata, MN 55391 | 2018-03-20 |
| 1730687757 | Global Home Care Inc | Home Health | 1001 Twelve Oaks Center Drive, Suite 1018, Wayzata, MN 55391 | 2018-01-24 |
| 1205362472 | Oraphanh Vongpheth Smith | Registered Nurse | 801 Twelve Oaks Center Drive, Suite 822, Wayzata, MN 55391 | 2017-05-10 |
| 1386189272 | Wayzata Endodontics, P.a. | Dentist | 101 Lake Street West, Suite 100, Wayzata, MN 55391 | 2016-12-30 |
| 1952763351 | Watershed Psychological Services | Clinic/Center | 4255 Pheasant Ridge Drive, Suite 412, Blaine, MN 55391 | 2016-03-24 |
| 1477923571 | Robert J. Floren | Marriage & Family Therapist | 801 Twelve Oaks Center Dr Ste 816a, Wayzata, MN 55391 | 2015-10-01 |
| 1194101055 | Bruce Martinson Family & Cosmetic Dentistry | Dentist | 317 E Wayzata Blvd, Wayzata, MN 55391 | 2015-08-03 |
| Find all providers in zip 55391 | ||||
| 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 |
|---|---|---|---|---|
| 1881005775 | Ebenezer Management Services | Assisted Living Facility | 875 Wayzata Blvd W, Wayzata, MN 55391-9418 | 2014-05-13 |
| 1740525229 | Meridian Manor Operatons LLC | Assisted Living Facility | 163 Wayzata Blvd W, Wayzata, MN 55391-1562 | 2012-12-10 |
| 1134425168 | Ggnsc Wayzata LLC | Assisted Living Facility | 15409 Wayzata Blvd, Wayzata, MN 55391-1402 | 2011-02-09 |
| 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 | ||||
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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.