Organization Active NPI

Suite Living Senior Care of Lakeville

  • Assisted Living Facility
  • Lakeville, MN
National Provider Identifier
1629708524
Registry record updated Jun 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
SUITE LIVING SENIOR CARE OF LAKEVILLE
Practice address
20949 Keokuk Ave
Lakeville, MN 55044
Phone
(651) 770-2273
NPI assigned
Jun 14, 2022
Last updated
Jun 14, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2022

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

Authorized official

Name
Audrey McElwain
Title
Director of Operations
Phone
(651) 770-2273

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X NU Primary

Addresses

Primary practice location

20949 Keokuk Ave
Lakeville, MN 55044

Mailing address

1824 Buerkle Rd
White Bear Lake, MN 55110-5245
Phone (651) 964-1092

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
24D2282504Suite Living Senior Care of Lakeville20949 Keokuk Ave, Lakeville, MN 55044Certificate of waiverMay 22, 2027

National Provider Directory

National Provider Directory

Locations

20949 Keokuk Ave
Lakeville, MN 55044

NPI Registry JSON

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

{
    "created_epoch": "1655164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655164800000",
    "number": "1629708524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1824 BUERKLE RD",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551105245",
            "telephone_number": "651-964-1092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20949 KEOKUK AVE",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "55044",
            "telephone_number": "651-770-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUITE LIVING SENIOR CARE OF LAKEVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-14",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-08",
        "status": "A",
        "authorized_official_last_name": "MCELWAIN",
        "authorized_official_first_name": "AUDREY",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "651-770-2273"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; 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.