St. Therese at Oxbow Lake

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

339337 Issued in MN

Legal business name

ST. THERESE AT OXBOW LAKE

Practice address

5200 Oak Grove Pkwy N
Brooklyn Park, MN 55443-4031

Phone

(763) 493-7000

Fax

(763) 493-7001

NPI assigned

May 23, 2008

Organization subpart

No

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

Authorized official

Name

Dinah Joy Martin

Title

Campus Administrator

Phone

(763) 493-7007

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1211500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211500800000",
    "number": "1114185436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 OAK GROVE PKWY N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554434031",
            "telephone_number": "763-493-7000",
            "fax_number": "763-493-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 OAK GROVE PKWY N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554434031",
            "telephone_number": "763-493-7000",
            "fax_number": "763-493-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. THERESE AT OXBOW LAKE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-23",
        "last_updated": "2008-05-23",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "DINAH",
        "authorized_official_middle_name": "JOY",
        "authorized_official_title_or_position": "CAMPUS ADMINISTRATOR",
        "authorized_official_telephone_number": "763-493-7007"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MN",
            "license": "339337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Brooklyn Park, MN
• Providers in Brooklyn Park, 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 May 23, 2008; 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.