Beyond Senior Living LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

BEYOND SENIOR LIVING LLC

Practice address

6281 Oakwood Rd
Woodbury, MN 55125-2020

Phone

(651) 200-0857

Fax

(651) 200-3084

NPI assigned

Feb 27, 2020

Organization subpart

No

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

Authorized official

Name

Angelina Senam SamNPI 1568015766

Title

Administrator

Phone

(651) 200-0857

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Beyond Senior Care LLC Former legal business name

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Angelina Senam Sam

  • Assisted Living Facility
  • Woodbury, MN
  • NPI 1568015766
  NPD Authorized official

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

{
    "created_epoch": "1582761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657152000000",
    "number": "1003440124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6281 OAKWOOD RD",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252020",
            "telephone_number": "651-493-3803",
            "fax_number": "651-200-3082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6281 OAKWOOD RD",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252020",
            "telephone_number": "651-200-0857",
            "fax_number": "651-200-3084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEYOND SENIOR LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-27",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A",
        "authorized_official_last_name": "SAM",
        "authorized_official_first_name": "ANGELINA",
        "authorized_official_middle_name": "SENAM",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "651-200-0857"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "638925",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beyond Senior Care LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Assisted Living Facility in Woodbury, MN
• Providers in Woodbury, MN by specialty
• Assisted Living Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.