Ms-Ac Mankato Ag Senior Living LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

MS-AC MANKATO AG SENIOR LIVING LLC

Doing business as

Autumn Grace

Practice address

118 Raven CT
Mankato, MN 56001-8431

Phone

(507) 388-5412

NPI assigned

Jan 3, 2017

Organization subpart

Yes

Parent organization

MERISTAR ACAS HOLDINGS, LLCAs reported in NPPES

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

Authorized official

Name

Robert Sweet

Title

Authorized Representative

Phone

(240) 595-6064

Specialties & licenses 1

Addresses

Other names 1

• Autumn Grace Doing business as

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

CLIA laboratory certificates

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

{
    "created_epoch": "1483401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483401600000",
    "number": "1346785144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 SPRING ST",
            "address_2": "STE 205",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209103616",
            "telephone_number": "240-595-6064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 RAVEN CT",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560018431",
            "telephone_number": "507-388-5412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MS-AC MANKATO AG SENIOR LIVING LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERISTAR ACAS HOLDINGS, LLC",
        "enumeration_date": "2017-01-03",
        "last_updated": "2017-01-03",
        "status": "A",
        "authorized_official_last_name": "SWEET",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "AUTHORIZED REPRESENTATIVE",
        "authorized_official_telephone_number": "240-595-6064"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Autumn Grace",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Robert C Morris, MD
• Zennor Morris Sr.
• Ellen Marie Morrow, LICSW
• Susan Eliabeth Morsching, LICSW
• Elizabeth Morton, PA
• Ms-Ac Mankato We Senior Living LLC (Water's Edge)
• Michael Much, DPT
• Michael Mwangi Muchiri, NP-C
• Elise Lauren Muehlenhardt, RBT
• Megan Elizabeth Mueller, M.S, CF-SLP

• Assisted Living Facility in Mankato, MN
• Providers in Mankato, 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 Jan 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.