Cedar Crest of Cosmos

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

FBL-171014162 Issued in MN

Legal business name

CEDAR CREST OF COSMOS

Practice address

130 Neptune St N
Cosmos, MN 56228-9610

Phone

(320) 587-7077

Fax

(320) 587-4299

NPI assigned

Apr 8, 2009

Last updated

Apr 8, 2009By 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

Damon M Ewald

Title

Business Manager

Phone

(320) 587-7077

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1239148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239148800000",
    "number": "1306089248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 NEPTUNE ST N",
            "city": "COSMOS",
            "state": "MN",
            "postal_code": "562289610",
            "telephone_number": "320-587-7077",
            "fax_number": "320-587-4299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 NEPTUNE ST N",
            "city": "COSMOS",
            "state": "MN",
            "postal_code": "562289610",
            "telephone_number": "320-587-7077",
            "fax_number": "320-587-4299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDAR CREST OF COSMOS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-08",
        "last_updated": "2009-04-08",
        "status": "A",
        "authorized_official_last_name": "EWALD",
        "authorized_official_first_name": "DAMON",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "320-587-7077"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MN",
            "license": "FBL-171014162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawna Adams
• Nicole Marie Alexander
• Amy Marie Atkins, BCBA, LBA
• Halii Kay Beilke
• Michelle Carlson
• City of Cosmos (Cosmos Ambulance Service)
• Megan Degner
• Misty Eystad
• Jaeleigh Suzanne Fern
• Christina Garcia

• Assisted Living Facility in Cosmos, MN
• Providers in Cosmos, 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 Apr 8, 2009; 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.