RIDGEWOOD MANOR NPI 1407280720

NPI Information

  • NPI: 1407280720
  • Provider Name: RIDGEWOOD MANOR
  • Classification: Custodial Care Facility - 311ZA0620X
  • Specialization: Adult Care Home
  • Entity Type: Organization
  • CLIA Number: 24D2124625
  • Address: 10038 215TH AVE NW
    ELK RIVER, MN
    ZIP 55330
  • Phone: (763) 607-6874

Map and Directions

Get Directions

NPI Details

RIDGEWOOD MANOR is an adult care home custodial care facility in Elk River, MN. The provider is a custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. RIDGEWOOD MANOR NPI is 1407280720. The provider is registered as an organization entity type.

The provider's business location address is:

10038 215TH AVE NW
ELK RIVER, MN
ZIP 55330-519
Phone: (763) 607-6874
Fax: (267) 350-9164

The provider's authorized official is Gregory M Petersen .
The authorized official title is Partner and has the following contact phone number (763) 607-6874.

The CLIA number assigned to this NPI record is 24D2124625 - other - comprehensive home care h with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/22/2013 and was last updated on 8/22/2013.

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
1311ZA0620XCustodial Care FacilityAdult Care Home1066808-1-AFCMINNESOTAYes

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

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI