NPIMap

Organization Active NPI

Cherrywood Advanced Living, LLC

  • Assisted Living Facility
  • St Cloud, MN
National Provider Identifier
1013350693
Registry record updated Apr 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
357491 Issued in MN
Legal business name
CHERRYWOOD ADVANCED LIVING, LLC
Practice address
1036 Voyageur St
St Cloud, MN 56303
Phone
(320) 257-7445
Fax
(320) 257-7447
NPI assigned
Apr 12, 2013
Organization subpart
No

National Provider Directory

National Provider Directory
Tax ID family
Cherrywood Advanced Living LLC10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

NPPES NPI Registry

Updated by the provider on Apr 12, 2013

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

Authorized official

Name
Wendy Hulsebus
Title
Chief Operating Officer
Phone
(320) 257-7445

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 357491 MN Primary

Addresses

Primary practice location

1036 Voyageur St
St Cloud, MN 56303

Mailing address

1685 4TH Ave N
Sauk Rapids, MN 56379-2708
Phone (320) 257-7445

Other identifiers 1

IdentifierTypeStateIssuer
360195OtherMNHOUSING WITH SERVICES LICENSE

Other names 1

  • Cherrywood St Cloud 1036 Doing business as

NPI Registry JSON

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

{
    "created_epoch": "1365724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365724800000",
    "number": "1013350693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1685 4TH AVE N",
            "city": "SAUK RAPIDS",
            "state": "MN",
            "postal_code": "563792708",
            "telephone_number": "320-257-7445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1036 VOYAGEUR ST",
            "city": "ST CLOUD",
            "state": "MN",
            "postal_code": "56303",
            "telephone_number": "320-257-7445",
            "fax_number": "320-257-7447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHERRYWOOD ADVANCED LIVING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-12",
        "last_updated": "2013-04-12",
        "status": "A",
        "authorized_official_last_name": "HULSEBUS",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "320-257-7445"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MN",
            "license": "357491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOUSING WITH SERVICES LICENSE",
            "identifier": "360195",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cherrywood St Cloud 1036",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St Cloud, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2013; 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.