NPIMap

Organization Active NPI

Covenant Living of Golden Valley

  • Skilled Nursing Facility
  • Golden Valley, MN
National Provider Identifier
1205935152
Registry record updated Aug 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
COVENANT LIVING OF GOLDEN VALLEY
Practice address
5825 Saint Croix Ave N
Golden Valley, MN 55422-4483
Phone
(763) 546-6125
Fax
(763) 546-8529
NPI assigned
Sep 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2019

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

Authorized official

Name
Elizabeth McLaren
Title
Associate Vice President of Health
Phone
(773) 878-4430

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X MN Primary

Addresses

Primary practice location

5825 Saint Croix Ave N
Golden Valley, MN 55422-4483

Mailing address

5825 Saint Croix Ave N
Golden Valley, MN 55422-4419
Phone (763) 546-6125

Other names 2

  • Colonial Acres Health Care Center Doing business as
  • Covenant Living of Golden Valley Care & Rehabilitation Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090929000179 MN Part A Provider - Skilled Nursing Facility 6709932064 Practice locations: Minneapolis, MN

Skilled nursing facility certification: CCN 245322

Legal name
COVENANT LIVING OF GOLDEN VALLEY
Doing business as
COVENANT LIVING OF GOLDEN VALLEY CARE & REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF (Medicare) only
Participating since
Jul 1, 1986
Last certification
May 22, 2025
Beds
88
Ownership / control type
Church Related
Multi-facility organization
Covenant Retirement Communitites
Organization structure
CorporationNon-profit
Incorporated
Dec 1, 1959 in MN
Enrollment address
5825 Saint Croix Ave N
Minneapolis, MN 55422-4419
Nursing home name
COVENANT LIVING OF GOLDEN VALLEY CARE & REHAB CTR
Affiliated entity
COVENANT LIVING

Care Compare: Nursing home

Medicare Care Compare
Listed as
Covenant Living of Golden Valley Care & Rehab CtrCCN 245322
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
5 of 5
Quality measures
4 of 5
Type
Medicare
Ownership
Non profit - Church related
Certified
Jul 1, 1986
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
8874.5 residents per day on average
Chain
Covenant Living15 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 17

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Andrew Vanover Individual Corporate DirectorBoard Member Jul 1, 2019
Pamela Christensen Individual Corporate DirectorBoard Member Jul 1, 2013
Covenant Living Communities & Services Organization, Skokie, IL Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 1966 100%
Kurt Kincannon Individual Corporate DirectorBoard Member Jul 1, 2019
Roger Oxendale Individual Corporate DirectorBoard Member Jul 1, 2017
David Erickson Individual Corporate OfficerSenior Vice President Jan 31, 2008
Richard Nelson Individual Corporate DirectorBoard Member Jul 1, 2019
Robert Martin Individual Corporate DirectorBoard Member Jul 1, 2019
Terri Cunliffe Individual Corporate OfficerPresident & Ceo Mar 19, 2009
W-2 Managing EmployeeCeo Mar 19, 2009
Sarah Bentley Individual Corporate DirectorBoard Member Jul 1, 2019
Mark C Eastburg Individual Corporate DirectorBoard Chair Jul 1, 2019
Kara E Davis Individual Corporate DirectorBoard Member Jul 1, 2019
Matt Manlove Individual Corporate DirectorVice Chair Jul 1, 2019
John Wenrich Individual Corporate DirectorBoard Member Jul 1, 2019
Rebekah Erickson Individual Corporate OfficerAssistant Secretary Jul 1, 2019
Jody Holt Individual Corporate OfficerCfo Jun 2, 2017
Operational/Managerial ControlBoard Member Jul 1, 2013
Dale Rinard Individual Corporate DirectorBoard Member Jul 1, 2019

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 16

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 16

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566864000000",
    "number": "1205935152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5825 SAINT CROIX AVE N",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224419",
            "telephone_number": "763-546-6125",
            "fax_number": "763-546-8529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5825 SAINT CROIX AVE N",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224483",
            "telephone_number": "763-546-6125",
            "fax_number": "763-546-8529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT LIVING OF GOLDEN VALLEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2019-08-27",
        "status": "A",
        "authorized_official_last_name": "MCLAREN",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "ASSOCIATE VICE PRESIDENT OF HEALTH",
        "authorized_official_telephone_number": "773-878-4430"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Colonial Acres Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Colonial Acres Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Covenant Living of Golden Valley Care & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Golden Valley, MN

Sources for this page

Verify at the official NPI Registry.