NPIMap

Organization Active NPI

FCSL Grand Rapids, LLC

Doing business as Diamond Willow Assisted Living of Grand Rapids

  • Assisted Living Facility
  • Grand Rapids, MN
National Provider Identifier
1548667694
Registry record updated Dec 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
370701 Issued in MN
Legal business name
FCSL GRAND RAPIDS, LLC
Doing business as
Diamond Willow Assisted Living of Grand Rapids
Practice address
949 SW 11TH Ave
Grand Rapids, MN 55744-3562
Phone
(218) 327-9463
NPI assigned
Dec 4, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2014

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

Authorized official

Name
Natalie Zeleznikar
Title
Owner
Phone
(218) 625-8488

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 370701 MN Primary

Addresses

Primary practice location

949 SW 11TH Ave
Grand Rapids, MN 55744-3562

Mailing address

2701 W Superior St
Suite 101
Duluth, MN 55806-1856
Phone (218) 625-8488

Other names 1

  • Diamond Willow Assisted Living of Grand Rapids Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Diamond Willow Assisted Living of Proctor25 organizations share this tax ID, including this one

Other organizations with this tax ID 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1417651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417651200000",
    "number": "1548667694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 W SUPERIOR ST",
            "address_2": "SUITE 101",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558061856",
            "telephone_number": "218-625-8488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "949 SW 11TH AVE",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557443562",
            "telephone_number": "218-327-9463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FCSL GRAND RAPIDS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-04",
        "last_updated": "2014-12-04",
        "status": "A",
        "authorized_official_last_name": "ZELEZNIKAR",
        "authorized_official_first_name": "NATALIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "218-625-8488"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MN",
            "license": "370701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diamond Willow Assisted Living of Grand Rapids",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Rapids, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2014; 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.