Mala Strana Alf LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

MALA STRANA ALF LLC

Practice address

999 Columbus Ave N
New Prague, MN 56071-2092

Phone

(952) 758-2511

NPI assigned

May 15, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Joshua Legum

Title

Manager

Phone

(516) 410-5209

Specialties & licenses 1

Addresses

Other names 1

• Mala Strana Assisted Living Doing business as

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

{
    "created_epoch": "1431648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431648000000",
    "number": "1376921841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "999 COLUMBUS AVE N",
            "city": "NEW PRAGUE",
            "state": "MN",
            "postal_code": "560712092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 COLUMBUS AVE N",
            "city": "NEW PRAGUE",
            "state": "MN",
            "postal_code": "560712092",
            "telephone_number": "952-758-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MALA STRANA ALF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-15",
        "last_updated": "2015-05-15",
        "status": "A",
        "authorized_official_last_name": "LEGUM",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "516-410-5209",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mala Strana Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jun Hong Liang, MD
• Danny Ray Luna, PA
• Peter Paul Ly, DPT
• Allyn Marie Mahowald, RDN, LD
• Main Street Dental
• Mala Strana Assisted Living
• Mala Strana Health Care LLC
• Foram Ashwin Mankodi, MBBS
• John Conrad Masberg, PT
• McKenzie Rae Masberg, PA-C

• Assisted Living Facility in New Prague, MN
• Providers in New Prague, 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 May 15, 2015; 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.