Renaissance Adult Day Care Inc.

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

License

1028893-3-ADC Issued in MN

Legal business name

RENAISSANCE ADULT DAY CARE INC.

Practice address

3045 Coon Rapids Blvd NW
Coon Rapids, MN 55433-3487

Phone

(763) 433-2980

Fax

(763) 433-2982

NPI assigned

Aug 9, 2018

Organization subpart

No

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

Authorized official

Name

David Matthew Baker

Title

President

Phone

(763) 898-2053

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1533772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665100800000",
    "number": "1528547650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3045 COON RAPIDS BLVD NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554333487",
            "telephone_number": "763-433-2980",
            "fax_number": "763-433-2982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3045 COON RAPIDS BLVD NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554333487",
            "telephone_number": "763-433-2980",
            "fax_number": "763-433-2982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE ADULT DAY CARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-09",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "763-898-2053"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "MN",
            "license": "1028893-3-ADC",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Day Care Clinic/Center in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Adult Day Care Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2022; 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.