CHP Maplewood MN Tenant Corp.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

HFID29005 Issued in MN

Legal business name

CHP MAPLEWOOD MN TENANT CORP.

Practice address

1870 E. Shore Drive
Maplewood, MN 55109

Phone

(651) 777-7784

NPI assigned

Feb 15, 2016

Last updated

Oct 30, 2023By 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

Mrs. Tracey B Bracco

Title

Senior Vice President

Phone

(407) 540-7576

Specialties & licenses 1

Addresses

Other names 1

• ALF Employer MN2, LLC Other name

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

{
    "created_epoch": "1455494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698624000000",
    "number": "1205295516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1870 E. SHORE DRIVE",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "55109",
            "telephone_number": "651-777-7784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1870 E. SHORE DRIVE",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "55109",
            "telephone_number": "651-777-7784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHP MAPLEWOOD MN TENANT CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-15",
        "last_updated": "2023-10-30",
        "status": "A",
        "authorized_official_last_name": "BRACCO",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "407-540-7576",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MN",
            "license": "HFID29005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ALF Employer MN2, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Nathaniel Chau
• Ambe Ernest Che, CNP
• Puneet S Cheema, MD
• Danny Chen
• Children's Theraplay, LLC
• Trenton Allen Christensen, PA-C
• Kristen Marie Chuba, PA-C
• Christine Knecht Church, PH.D. LP
• Margaret Phelps Chute, MD
• Johnathan Cicchese, DPT

• Assisted Living Facility in Maplewood, MN
• Providers in Maplewood, 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 Oct 30, 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.