Sophies Manor Assisted Living, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

334231 Issued in MN

Legal business name

SOPHIES MANOR ASSISTED LIVING, INC.

Practice address

17500 Ranch Dr
Pine City, MN 55063-5502

Phone

(320) 629-2064

Fax

(320) 629-4918

NPI assigned

Mar 8, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sandra Jo Holt

Title

Administrator

Phone

(320) 629-2064

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114058633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17500 RANCH DR",
            "city": "PINE CITY",
            "state": "MN",
            "postal_code": "550635502",
            "telephone_number": "320-629-2064",
            "fax_number": "320-629-4918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17500 RANCH DR",
            "city": "PINE CITY",
            "state": "MN",
            "postal_code": "550635502",
            "telephone_number": "320-629-2064",
            "fax_number": "320-629-4918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOPHIES MANOR ASSISTED LIVING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOLT",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "320-629-2064"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MN",
            "license": "334231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gretchen Blaufuss Skalicky, D.C.
• Shelley Ann Skarda, B.S. LADC
• Cheryl K Smetana McHugh, LICSW
• Soliant Health
• Mari Margaret Soma-Ringness, MS, LPC
• Thomas M Staloch, LMFT
• Kim E Stephan, LADC
• Kelly Swanson, MA, LPCC, RPT
• Aaron C Terning, PHARM.D.
• Therapeutic Services Agency Inc

• Assisted Living Facility in Pine City, MN
• Providers in Pine City, 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 Aug 22, 2020; 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.