Amazing Love Elderly Care Center LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

1083851 Issued in MN

Legal business name

AMAZING LOVE ELDERLY CARE CENTER LLC

Practice address

7807 Emerald Rd
Randall, MN 56475-2428

Phone

(320) 749-2485

NPI assigned

Nov 3, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Penny Jean Poling

Title

Owner/Partner

Phone

(218) 296-1872

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1478131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478131200000",
    "number": "1003368309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 10TH ST NW",
            "city": "STAPLES",
            "state": "MN",
            "postal_code": "564795118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7807 EMERALD RD",
            "city": "RANDALL",
            "state": "MN",
            "postal_code": "564752428",
            "telephone_number": "320-749-2485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMAZING LOVE ELDERLY CARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-03",
        "last_updated": "2016-11-03",
        "status": "A",
        "authorized_official_last_name": "POLING",
        "authorized_official_first_name": "PENNY",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "OWNER/PARTNER",
        "authorized_official_telephone_number": "218-296-1872"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "MN",
            "license": "1083851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Care Home Facility in Randall, MN
• Providers in Randall, MN by specialty
• Adult Care Home Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.