SENIOR CARE WOODBURY LLC NPI 1760607097

NPI Information

NPI: 1760607097
Provider Name: SENIOR CARE WOODBURY, LLC

Doing Business As: WOODBURY VILLA

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization
Address:
7008 LAKE ROAD
WOODBURY, MN
ZIP 55125
Phone: (651) 731-5501
Get Directions

SENIOR CARE WOODBURY, LLC is an assisted living facility in Woodbury, 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. SENIOR CARE WOODBURY, LLC NPI is 1760607097. The provider is registered as an organization entity type.
The provider Is Doing Business As Woodbury Villa.

The provider's business location address is:

7008 LAKE ROAD
WOODBURY, MN
ZIP 55125-824
Phone: (651) 731-5501

The provider's authorized official is Tricia Marie Lies .
The authorized official title is Sr Director Revenue Cycle and has the following contact phone number (612) 286-1170.

The enumeration date for this NPI number is 4/13/2007 and was last updated on 4/25/2024.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	310400000X	Assisted Living Facility			MINNESOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	4980442	OTHER	MINNESOTA	4980442
2	796108100	MEDICAID	MINNESOTA
3	131445	OTHER	MINNESOTA	UCARE
4	115925	OTHER	MINNESOTA	HEALTHPARTNERS

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: 4/28/2024

NPI Synchronization or Removal

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