The Legacy of St Michael

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

THE LEGACY OF ST MICHAEL

Practice address

4400 Lange Ave NE
Saint Michael, MN 55376-9528

Phone

(763) 367-0970

NPI assigned

Feb 9, 2010

Last updated

Feb 9, 2010By 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

Howie Groff

Title

President

Phone

(952) 888-2923

Specialties & licenses 1

Addresses

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": "1265673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265673600000",
    "number": "1417289968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 LANGE AVE NE",
            "city": "SAINT MICHAEL",
            "state": "MN",
            "postal_code": "553769528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 LANGE AVE NE",
            "city": "SAINT MICHAEL",
            "state": "MN",
            "postal_code": "553769528",
            "telephone_number": "763-367-0970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE LEGACY OF ST MICHAEL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-09",
        "last_updated": "2010-02-09",
        "status": "A",
        "authorized_official_last_name": "GROFF",
        "authorized_official_first_name": "HOWIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "952-888-2923"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Supervalu Pharmacies Inc (Cub Pharmacy #1965)
• Grace Elizabeth Szymanski
• Nai Vivian Takybajouah
• Breezy Rae Tate, MSW, LICSW
• Katrina Tauchen
• Rose Thunder, CMT
• Ross Gerard Tienter
• Jacob E Todd, PT, DPT
• Nancy Ann Tomanek, MA, LAMFT
• John Carl Torkelson, MDIV, LMFT

• Assisted Living Facility in Saint Michael, MN
• Providers in Saint Michael, 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 Feb 9, 2010; 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.