Brooklyn Park Assisted Living

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

BROOKLYN PARK ASSISTED LIVING

Practice address

7711 Humboldt Ave N
Brooklyn Park, MN 55444-2167

Phone

(612) 200-0901

NPI assigned

Jun 7, 2021

Organization subpart

No

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

Authorized official

Name

Michael Crow

Title

Owner

Phone

(612) 986-3859

Specialties & licenses 1

Addresses

Other names 1

• The Lodge of Brooklyn Park Doing business as

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

{
    "created_epoch": "1623024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623024000000",
    "number": "1245807510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 46104",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554460104",
            "telephone_number": "612-200-0901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7711 HUMBOLDT AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554442167",
            "telephone_number": "612-200-0901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKLYN PARK ASSISTED LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-07",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A",
        "authorized_official_last_name": "CROW",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-986-3859"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Lodge of Brooklyn Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Amy Buggert, RN
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• Assisted Living Facility in Brooklyn Park, MN
• Providers in Brooklyn Park, 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 Jun 7, 2021; 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.