GOPHER (MAPLE GROVE) TRS LLC NPI 1598416430

NPI Information

  • NPI: 1598416430
  • Provider Name: GOPHER (MAPLE GROVE) TRS LLC
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • Doing Business As: HAVENWOOD OF MAPLE GLEN
  • CLIA Number: 24D2211216
  • Address: 18695 73RD AVE N
    MAPLE GROVE, MN
    ZIP 55311
  • Phone: (763) 363-8640

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NPI Details

GOPHER (MAPLE GROVE) TRS LLC is an assisted living facility in Maple Grove, 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. GOPHER (MAPLE GROVE) TRS LLC NPI is 1598416430. The provider is registered as an organization entity type.
The provider Is Doing Business As Havenwood Of Maple Glen.

The provider's business location address is:

18695 73RD AVE N
MAPLE GROVE, MN
ZIP 55311-604
Phone: (763) 363-8640

The provider's authorized official is Laura Sims .
The authorized official title is President and has the following contact phone number (214) 754-8623.

The CLIA number assigned to this NPI record is 24D2211216 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/12/2022 and was last updated on 1/12/2022.

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 FacilityYes

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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