Suite Living of Prior Lake

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SUITE LIVING OF PRIOR LAKE

Practice address

5800 Credit River Rd SE
Prior Lake, MN 55372

Phone

(651) 770-2273

NPI assigned

Jun 14, 2021

Organization subpart

No

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

Authorized official

Name

Ms. Audrey McElwain

Title

Director

Phone

(651) 770-2273

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1623628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679616000000",
    "number": "1316515638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1824 BUERKLE RD",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551105245",
            "telephone_number": "651-770-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 CREDIT RIVER RD SE",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "55372",
            "telephone_number": "651-770-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUITE LIVING OF PRIOR LAKE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-14",
        "last_updated": "2023-03-24",
        "certification_date": "2023-03-23",
        "status": "A",
        "authorized_official_last_name": "MCELWAIN",
        "authorized_official_first_name": "AUDREY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "651-770-2273",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASSISTANT LIVING/ MEMORY CARE",
            "identifier": "=========",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cassandra Stewart, LPCC, LADC
• Katherine Stewart
• Taylor Stotz, MA, LPCC, R-DMT
• Sarah Strayer, IBCLC
• Noah Strom
• Debra Kay Sumner, DDS
• Nicole Theisen, CRNA
• Julie Marie Thompson, RN
• Thrive Therapy Center
• Gillian Tibbetts, PSYD

• Assisted Living Facility in Prior Lake, MN
• Providers in Prior Lake, 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 Mar 24, 2023; 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.