Organization Active NPI

Ecumen

Doing business as Ecumen Duluth The Shores

  • Assisted Living Facility
  • Duluth, MN
National Provider Identifier
1508716986
Registry record updated Feb 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
ECUMEN
Doing business as
Ecumen Duluth The Shores
Practice address
4000 London Rd
Duluth, MN 55804-2220
Phone
(218) 625-8280
NPI assigned
Feb 3, 2026
Last updated
Feb 11, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2026

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

Authorized official

Name
Douglas Harrison
Title
Cfo
Phone
(651) 766-4300

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X NU Primary
Alzheimer Center (Dementia Center) 311500000X NU

Addresses

Primary practice location

4000 London Rd
Duluth, MN 55804-2220

Mailing address

3530 Lexington Ave N
Shoreview, MN 55126-8166
Phone (651) 766-4300

Other identifiers 1

IdentifierTypeStateIssuer
A487677000MedicaidMN

Other names 1

  • Ecumen Duluth The Shores Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D1085847Ecumen Duluth the Shores4000 London Road, Duluth, MN 55804Certificate of waiverJun 26, 2028

National Provider Directory

National Provider Directory
Tax ID family
Mahnomen Health Center43 organizations share this tax ID, including this one

Other organizations with this tax ID 42

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

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1770076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770768000000",
    "number": "1508716986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3530 LEXINGTON AVE N",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "551268166",
            "telephone_number": "651-766-4300",
            "fax_number": "651-766-4479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 LONDON RD",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558042220",
            "telephone_number": "218-625-8280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ECUMEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-03",
        "last_updated": "2026-02-11",
        "certification_date": "2026-02-11",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "651-766-4300"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A487677000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ecumen Duluth The Shores",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Duluth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2026; 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.