Aviv Health Care, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

327079 Issued in MN

Legal business name

AVIV HEALTH CARE, INC.

Practice address

275 Penn Ave N
Minneapolis, MN 55405-1216

Phone

(612) 377-4723

Fax

(612) 377-0294

NPI assigned

Sep 15, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Tony Pasell

Title

Comptroller

Phone

(952) 259-5222

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• BRYN MAWR HEALTH CARE CENTER Doing business as

Locations

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

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235124231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4509 MINNETONKA BLVD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554164027",
            "telephone_number": "952-259-5224",
            "fax_number": "952-920-5207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 PENN AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554051216",
            "telephone_number": "612-377-4723",
            "fax_number": "612-377-0294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVIV HEALTH CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PASELL",
        "authorized_official_first_name": "TONY",
        "authorized_official_title_or_position": "COMPTROLLER",
        "authorized_official_telephone_number": "952-259-5222",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MN",
            "license": "327079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30329",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "7122599",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "7100254",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8711BR",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "NH0006",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BRYN MAWR HEALTH CARE CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Yuval Avidan, MD
• Enrique J Avila III, MD
• Katheleen Avila, M.A. LIC PSYCHOLOGIS
• Emily Aviles, ACNP
• Cheryl R. Avina, M.ED.
• Aviva Therapy & Healing
• Avivo
• Avivo
• Avivo
• Avivo

• Skilled Nursing Facility in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Skilled Nursing Facility in Minnesota

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.