The Homestead at Anoka, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

330543 Issued in MN

Legal business name

THE HOMESTEAD AT ANOKA, INC.

Doing business as

Anoka Rehabilitation and Living Center

Practice address

3000 4TH Ave
Anoka, MN 55303-1203

Phone

(763) 528-6400

Fax

(763) 528-6479

NPI assigned

Jul 21, 2006

Last updated

Jan 12, 2021By 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

Nancy Gavin

Title

Assistant Secretary

Phone

(612) 428-7840

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• Anoka Rehabilitation and Living Center Doing business as

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1326069642. Details of each certification follow.

• CCN 245205 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 245205

Legal name

THE HOMESTEAD AT ANOKA INC

Doing business as

ANOKA REHABILITATION AND LIVING CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Feb 7, 1976

Last certification

Jul 18, 2024

Beds

120

Ownership / control type

Nonprofit Corporation

Multi-facility organization

Volunteers of America National Service

Organization structure

CorporationNon-profit

Incorporated

Aug 16, 2010 in MN

Enrollment address

3000 4TH Ave
Anoka, MN 55303-1203

Nursing home name

ANOKA REHABILITATION AND LIVING CENTER

Affiliated entity

VOLUNTEERS OF AMERICA SENIOR LIVING

Listed as

Anoka Rehabilitation and Living CenterCCN 245205 · All quality measures

Overall star rating

4 of 5

Health inspections

3 of 5

Staffing

5 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

Non profit - Corporation

Certified

Feb 7, 1976

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

120114.0 residents per day on average

Chain

Volunteers of America Senior Living6 facilities in the chain

Penalties (3 years)

2Fines totaling $24,297

Processed by Care Compare on Aug 1, 2026.

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

CLIA laboratory certificates

Tax ID family

Anoka Rehabilitation and Living Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• The Homestead at Anoka, Inc.

  dba The Homestead at Anoka

  • Assisted Living Facility
  • Anoka, MN
  • NPI 1609447911
  NPD tax ID

All disclosed owners & managing parties 20

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• James A Lee, MD

  • Family Medicine Physician
  • Minneapolis, MN
  • NPI 1447226410

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

• Homestead at Rochester, Inc.

  dba Rochester Rehabilitation and Living Center

  • Skilled Nursing Facility
  • Rochester, MN
  • NPI 1013347780

  Volunteers of America National Services

  CMS ownership
• Volunteers of America Care Facilities

  dba Valley Manor Care Center

  • Skilled Nursing Facility
  • Montrose, CO
  • NPI 1053332403

  Volunteers of America National Services

  CMS ownership
• Volunteers of America Care Facilities

  dba Horizons Carc Center

  • Skilled Nursing Facility
  • Eckert, CO
  • NPI 1285795336

  Volunteers of America National Services

  CMS ownership

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Cynthia A Carlson, MD

  • Family Medicine Physician
  • Minneapolis, MN
  • NPI 1427035401
  NPD (past)
• Scott J Fairbairn, M.D.

  • Geriatric Medicine (Family Medicine) Physician
  • Minneapolis, MN
  • NPI 1174553747
  NPD (past)
• James A Lee, MD

  • Family Medicine Physician
  • Minneapolis, MN
  • NPI 1447226410
  NPD (past)
• Mylin Concepcion West, M.D.

  • Family Medicine Physician
  • Coon Rapids, MN
  • NPI 1659472280
  NPD (past)

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• James A Lee, MD

  • Family Medicine Physician
  • Minneapolis, MN
  • NPI 1447226410

  Nursing home

  Care Compare affiliation
• Mylin Concepcion West, M.D.

  • Family Medicine Physician
  • Coon Rapids, MN
  • NPI 1659472280

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610409600000",
    "number": "1326069642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7485 OFFICE RIDGE CIR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553443690",
            "telephone_number": "952-941-0305",
            "fax_number": "952-941-0428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 4TH AVE",
            "city": "ANOKA",
            "state": "MN",
            "postal_code": "553031203",
            "telephone_number": "763-528-6400",
            "fax_number": "763-528-6479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE HOMESTEAD AT ANOKA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A",
        "authorized_official_last_name": "GAVIN",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "612-428-7840"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MN",
            "license": "330543",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "261960100",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "7111783",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "6C77AN",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "U-CARE",
            "identifier": "NH0132",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HP",
            "identifier": "92334",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anoka Rehabilitation and Living Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Anoka Rehabilitation and Living Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Delaney Jo Taylor
• Tenere Home Care Services, LLC
• Kari Lynn Tessum, ARNP
• Merrah Thao
• The Estates at Anoka LLC (The Estate at Twin RIvers)
• The Homestead at Anoka, Inc. (The Homestead at Anoka)
• The Kaleidoscope View, Relational Therapy and Wellness
• Bethany Anne Thompson, APRN, CNM
• McKenzie Savanna Thompson
• Frederick Delbert Toenniges, MA, CAC, LPCC

• Skilled Nursing Facility in Anoka, MN
• Providers in Anoka, 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 Jan 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.