Evans Park, Inc.

Primary specialty

HomemakerTaxonomy code 376J00000X

Legal business name

EVANS PARK, INC.

Practice address

300 Evans Ave NW
Elk River, MN 55330-2649

Phone

(763) 241-4430

NPI assigned

May 30, 2019

Last updated

May 30, 2019By the provider in NPPES

Organization subpart

Yes

Parent organization

GUARDIAN ANGELS OF ELK RIVERAs reported in NPPES

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

Authorized official

Name

Troy Hanson

Title

VP/Cfo

Phone

(763) 241-4445

Specialties & licenses 1

Addresses

Tax ID family

Evans Park Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

• Evans Park, Inc

  dba Engel Haus

  • Assisted Living Facility
  • Albertville, MN
  • NPI 1043700073
  NPD tax ID
• Evans Park, Inc

  dba Guardian Angels By The Lake

  • Assisted Living Facility
  • Elk River, MN
  • NPI 1346730363
  NPD tax ID
• Evans Park, Inc

  dba Riverview Landing

  • Assisted Living Facility
  • Otsego, MN
  • NPI 1932722584
  NPD tax ID

Locations

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

{
    "created_epoch": "1559174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559174400000",
    "number": "1427616952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 FREEPORT AVE NW",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553301873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 EVANS AVE NW",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553302649",
            "telephone_number": "763-241-4430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVANS PARK, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GUARDIAN ANGELS OF ELK RIVER",
        "enumeration_date": "2019-05-30",
        "last_updated": "2019-05-30",
        "status": "A",
        "authorized_official_last_name": "HANSON",
        "authorized_official_first_name": "TROY",
        "authorized_official_title_or_position": "VP/CFO",
        "authorized_official_telephone_number": "763-241-4445"
    },
    "taxonomies": [
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Burton Erickson, MD
• Kendra Merrie Erickson
• Marisa Erickson
• Cyan Renae Evanoff
• Evans Park, Inc (Guardian Angels By The Lake)
• Brianna Faber
• Amy L Fair, M.D.
• Fairview Clinics (M Health Fairview Clinic - Elk River)
• Fairview Pharmacy Services LLC (Fairview Northland Pharmacy Elk River)
• Faith Home Assisted Living

• Homemaker in Elk River, MN
• Providers in Elk River, MN by specialty
• Homemaker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2019; 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.