GGNSC ST. PAUL LAKE RIDGE LLC (NPI# 1912958000) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912958000 |
| Entity Type | Organization |
| Organization Name | GGNSC ST. PAUL LAKE RIDGE LLC |
| Other Organization Name | GOLDEN LIVINGCENTER - LAKE RIDGE |
| Practice Address |
2727 Victoria St N Roseville MN 55113-2040 |
| Practice Telephone | 6514835431 |
| Practice Fax Number | 6514862451 |
| Mailing Telephone | 6514835431 |
| Mailing Fax Number | 6514862451 |
| Enumeration Date | 2006-05-13 |
| Last Update Date | 2014-07-16 |
| Authorized Official Name | HOLLY A. RASMUSSEN-JONES (SECRETARY) |
| Authorized Official Telephone | 4792014835 |
| Is Organization Subpart | Y |
| Parent Organization Name | GGNSC EQUITY HOLDINGS LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities | ||
| Y | 314000000X | Skilled Nursing Facility | 332012 | MN | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | BLUE CROSS MINNESOTA | 8R13LA | 01 |
| MN | UCARE MN | NH0075 | 01 |
| MN | MEDICA CHOICE | 7122514 | 01 |
| MN | 264638200 | 05 | |
| MN | HEALTH PARTNERS MN | 115255 | 01 |
| MN | SECURITY HEALTH PLAN | 545105 | 01 |
| MN | MEDICA SELECTCARE | 7100287 | 01 |
| Other Name | Type Code |
|---|---|
| Golden LivingCenter - Lake Ridge | Doing Business As Name - Organization |
| Street Address |
2727 VICTORIA ST N |
| City | ROSEVILLE |
| State | MN |
| Zip Code | 55113-2040 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497293963 | Roseville Assisted Living LLC | Assisted Living Facility | 2727 Victoria St N, Roseville, MN 55113-3029 | 2017-02-06 |
| 1861930331 | Estates At Roseville LLC | Skilled Nursing Facility | 2727 Victoria St N, Roseville, MN 55113-3029 | 2017-02-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396384376 | Zachary Mattson | Physician Assistant | Regus Coworking Space 2355 Highway 36 West, Suite 400, Office #427, Roseville, MN 55113 | 2019-12-23 |
| 1467010330 | Ahmed Issa | Student in an Organized Health Care Education/Training Program | 1550 Larpenteur Ave W, Apt 235, St Paul, MN 55113 | 2019-06-05 |
| 1821653833 | Suite Living Senior Care of Little Canada | Assisted Living Facility | 2740 Rice Street, Little Canada, MN 55113 | 2019-05-06 |
| 1902370505 | Diverse Assessments and Treatment, LLC | Psychologist | 1935 Cty Rd B2 W Ste 270, Roseville, MN 55113 | 2019-01-16 |
| 1588138473 | Applewood Home Health Care, LLC | Home Health | 2021 E Hennepin Avenue # 402-1, Minneapolis, MN 55113 | 2019-01-14 |
| 1699251520 | Optum Infusion Services 500, Inc. | Durable Medical Equipment & Medical Supplies | 2685 Patton Rd, Roseville, MN 55113 | 2018-07-13 |
| 1083104145 | Suite Living Senior Care of Roseville | Assisted Living Facility | 197 County Road B2 W, Roseville, MN 55113 | 2018-05-15 |
| 1477055796 | Sunrise Residential Services LLC | Home Health | 216 Maple Ln, Roseville, MN 55113 | 2018-03-02 |
| 1194223024 | Alissa Hoff | Specialist | 1595 Mn 36 - 584 10 Rosedale Center, Roseville, MN 55113 | 2018-01-25 |
| 1841705118 | Kingsland Care Services Incorporated | Case Management | 2301 Rice Street, Suite 101, Roseville, MN 55113 | 2017-12-08 |
| Find all providers in zip 55113 | ||||
| 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 |
|---|---|---|---|---|
| 1417354200 | Rhema-roseville Operating LLC | Skilled Nursing Facility | 25375 Kelly Rd, Roseville, MI 48066-4960 | 2014-11-24 |
| 1710026869 | Rv Facility Inc | Skilled Nursing Facility | 600 Sunrise Ave, Roseville, CA 95661-4110 | 2007-02-05 |
| 1881768323 | Extendicare Homes, Inc. | Skilled Nursing Facility | 1000 Lovell Ave W, Roseville, MN 55113-4419 | 2006-11-17 |
| 1518068907 | S.c.a.r.c. Inc | Skilled Nursing Facility | 310 Oak Ridge Dr, Roseville, CA 95661-3420 | 2006-09-26 |
| 1225079684 | 527 Capital Group | Skilled Nursing Facility | 145 S Chamberlain St, Roseville, IL 61473-9581 | 2006-06-09 |
| 1922088780 | Henry Ford Continuing Care Corp | Skilled Nursing Facility | 25375 Kelly Road, Roseville, MI 48066-4960 | 2006-01-18 |
| 1548269863 | Sierra Hills Care Center, Inc. | Skilled Nursing Facility | 1139 Cirby Way, Roseville, CA 95661-4421 | 2005-07-19 |
| 1154320463 | Roseville Care Center, Inc. | Skilled Nursing Facility | 1161 Cirby Way, Roseville, CA 95661-4421 | 2005-07-19 |
| 1568460293 | Presbyterian Homes of Roseville | Skilled Nursing Facility | 1910 County Road D W, Roseville, MN 55112-3503 | 2005-07-07 |
| 1578025482 | Rosebay, LLC | Skilled Nursing Facility | 310 Oak Ridge Dr, Roseville, CA 95661-3420 | 2019-04-01 |
| Find all providers in ROSEVILLE | ||||
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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.