Cedar House LLC

Primary specialty

Lodging ProviderTaxonomy code 177F00000X

Legal business name

CEDAR HOUSE LLC

Practice address

3300 County Road 10
Brooklyn Center, MN 55429-3072

Phone

(651) 706-2670

NPI assigned

May 20, 2020

Organization subpart

No

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

Authorized official

Name

Vincent Jerome King

Title

Owner

Phone

(651) 706-2670

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1589932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710460800000",
    "number": "1164045472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9300 30TH AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554272305",
            "telephone_number": "651-706-2670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 COUNTY ROAD 10",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554293072",
            "telephone_number": "651-706-2670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDAR HOUSE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-20",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-04",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_middle_name": "JEROME",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-706-2670"
    },
    "taxonomies": [
        {
            "code": "174200000X",
            "taxonomy_group": "",
            "desc": "Meals",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "177F00000X",
            "taxonomy_group": "",
            "desc": "Lodging",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Louise Carriere, MED, LPCC
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• Eunice Chang, O.D.
• Macy Chang

• Lodging Provider in Brooklyn Center, MN
• Providers in Brooklyn Center, MN by specialty
• Lodging Provider in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2024; 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.