Ancora Healthcare LLC

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

Legal business name

ANCORA HEALTHCARE LLC

Practice address

8017 Van Buren St NE
Spring Lake Park, MN 55432-2038

Phone

(612) 615-0061

NPI assigned

Apr 26, 2022

Last updated

Mar 2, 2023By 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

Mr. Emmanuel D Williams

Title

Administrator

Phone

(612) 615-0061

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1650931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677715200000",
    "number": "1518601400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11050 CREEKSIDE LN",
            "city": "OSSEO",
            "state": "MN",
            "postal_code": "553692687",
            "telephone_number": "612-615-0061",
            "fax_number": "763-322-9278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8017 VAN BUREN ST NE",
            "city": "SPRING LAKE PARK",
            "state": "MN",
            "postal_code": "554322038",
            "telephone_number": "612-615-0061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANCORA HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-26",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "EMMANUEL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "612-615-0061",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility (Mental Illness) in Spring Lake Park, MN
• Providers in Spring Lake Park, MN by specialty
• Assisted Living Facility (Mental Illness) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2023; 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.