Organization Active NPI

Onamia Area Assisted Living

Doing business as Lake Song Assisted Living

  • Assisted Living Facility
  • Onamia, MN
National Provider Identifier
1205959830
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
ONAMIA AREA ASSISTED LIVING
Doing business as
Lake Song Assisted Living
Practice address
206 N Elm St
Onamia, MN 56359-4530
Phone
(320) 532-2000
Fax
(320) 532-3833
NPI assigned
Apr 9, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Shelly Hanneken, R.N.
Title
Health Coordinator
Phone
(320) 532-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X MN Primary

Addresses

Primary practice location

206 N Elm St
Onamia, MN 56359-4530

Mailing address

206 N Elm St
PO Box 129
Onamia, MN 56359-0129
Phone (320) 532-2000

Other names 1

  • Lake Song Assisted Living Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D2268921Lake Song Assisted Living206 Elm Street North, Onamia, MN 56359Certificate of waiverSep 19, 2026

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205959830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 N ELM ST",
            "address_2": "PO BOX 129",
            "city": "ONAMIA",
            "state": "MN",
            "postal_code": "563590129",
            "telephone_number": "320-532-2000",
            "fax_number": "320-532-3833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 N ELM ST",
            "city": "ONAMIA",
            "state": "MN",
            "postal_code": "563594530",
            "telephone_number": "320-532-2000",
            "fax_number": "320-532-3833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONAMIA AREA ASSISTED LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HANNEKEN",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_title_or_position": "HEALTH COORDINATOR",
        "authorized_official_telephone_number": "320-532-2000",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Song Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Onamia, MN

Sources for this page

  • 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.
  • 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.