WENDIGO PINES ASSISTED LIVING NPI 1205913613

NPI Information

  • NPI: 1205913613
  • Provider Name: WENDIGO PINES ASSISTED LIVING
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • Address: 20371 WENDIGO PARK RD
    GRAND RAPIDS, MN
    ZIP 55744
  • Phone: (218) 326-6900

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NPI Details

WENDIGO PINES ASSISTED LIVING is an assisted living facility in Grand Rapids, 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. WENDIGO PINES ASSISTED LIVING NPI is 1205913613. The provider is registered as an organization entity type.

The provider's business location address is:

20371 WENDIGO PARK RD
GRAND RAPIDS, MN
ZIP 55744
Phone: (218) 326-6900
Fax: (218) 326-6900

The provider's authorized official is Raisa Povlovna Kotula .
The authorized official title is Rn Owner and has the following contact phone number (218) 326-6900.

The enumeration date for this NPI number is 11/1/2006 and was last updated on 8/22/2020.

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
1310400000XAssisted Living Facility333801MINNESOTAYes

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: 11/21/2025

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