Walnut Grove Home

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

WALNUT GROVE HOME

Practice address

13708 Portland Ave
Burnsville, MN 55337-4128

Phone

(320) 223-9249

NPI assigned

Sep 12, 2023

Organization subpart

No

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

Authorized official

Name

Jinyi Slagle Wu

Title

President

Phone

(320) 223-9249

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1694476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694476800000",
    "number": "1104603299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6601 ZIRCON LN N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553111371",
            "telephone_number": "320-223-9249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13708 PORTLAND AVE",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553374128",
            "telephone_number": "320-223-9249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALNUT GROVE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-12",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A",
        "authorized_official_last_name": "WU",
        "authorized_official_first_name": "JINYI",
        "authorized_official_middle_name": "SLAGLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "320-223-9249"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co
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• Margaret Wallace, RD, LD
• Walmart Inc.
• Maria Jessenia Walsh, DDS
• Abigail Grace Walter
• Kristy Carol Wamsher, CRTT
• Yixuan Wang
• Heather Ward, BCBA

• All providers in Burnsville, MN
• Assisted Living Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; 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.