4 Seasons at Moorhead LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

4 SEASONS AT MOORHEAD LLC

Practice address

2921 6TH Ave N
Moorhead, MN 56560-2594

Phone

(218) 359-9000

Fax

(218) 359-0491

NPI assigned

Oct 17, 2006

Organization subpart

No

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

Authorized official

Name

Mr. John Nielson

Title

President

Phone

(218) 359-9000

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609956069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2921 6TH AVE N",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565602594",
            "telephone_number": "218-359-9000",
            "fax_number": "218-359-0491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2921 6TH AVE N",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565602594",
            "telephone_number": "218-359-9000",
            "fax_number": "218-359-0491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "4 SEASONS AT MOORHEAD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NIELSON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "218-359-9000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Moorhead, MN
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.