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NINE MILE CATERED LIVING NPI 1295008787


NPI Information

NPI: 1295008787
Provider Name: NINE MILE CATERED LIVING

Doing Business As: NINE MILE CREEK SENIOR LIVING

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization

CLIA Number: 24D2008534

Address:
2301 VILLAGE LN
BLOOMINGTON, MN
ZIP 55431
Phone: (952) 888-0731
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NINE MILE CATERED LIVING is an assisted living facility in Bloomington, MN. The provider is 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. NINE MILE CATERED LIVING NPI is 1295008787. The provider is registered as an organization entity type.
The provider Is Doing Business As Nine Mile Creek Senior Living.

The provider's business location address is:

2301 VILLAGE LN
BLOOMINGTON, MN
ZIP 55431-810
Phone: (952) 888-0731
Fax: (952) 884-2191

The provider's authorized official is Karen Marie Larson .
The authorized official title is Housing Manager and has the following contact phone number (952) 888-0731.

The CLIA number assigned to this NPI record is 24D2008534 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/15/2012 and was last updated on 2/15/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1310400000XAssisted Living Facility353396MINNESOTAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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