Active NPI
Ecumen
- Assisted Living Facility
- Maplewood, MN
National Provider Identifier
1649484601
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- License
- 331964
- Legal business name
- ECUMEN
- Practice address
- 1200 Lakewood Dr N
Maplewood, MN 55119-7601 - Phone
- (651) 770-1111
- NPI assigned
- May 9, 2007
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kathryn R Roberts
- Title
- Ceo
- Phone
- (651) 766-4300
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | 331964 | MN | Primary |
Addresses
Primary practice location
1200 Lakewood Dr N
Maplewood, MN 55119-7601
Mailing address
3530 Lexington Ave N
Shoreview, MN 55126-8164
Phone (651) 766-4300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 504158900 | Medicaid | MN |
Other names 1
- Lakeview Commons
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 24D0996196 | Ecumen Lakeview Commons | Certificate of waiver | Feb 11, 2028 |
National Provider Directory
National Provider Directory- Tax ID family
- Ecumen Properties Inc
Other organizations with this tax ID 42
Organizations that report the same tax identification number in the National Provider Directory.
-
- Assisted Living Facility
- Owatonna, MN
- NPI 1124234554
-
- Assisted Living Facility
- Worthington, MN
- NPI 1265646236
-
dba Ecumen Lakeshore Transportation
- Non-emergency Medical Transport (VAN)
- Duluth, MN
- NPI 1376800045
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178668800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1649484601",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3530 LEXINGTON AVE N",
"city": "SHOREVIEW",
"state": "MN",
"postal_code": "551268164",
"telephone_number": "651-766-4300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 LAKEWOOD DR N",
"city": "MAPLEWOOD",
"state": "MN",
"postal_code": "551197601",
"telephone_number": "651-770-1111"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ECUMEN",
"organizational_subpart": "NO",
"enumeration_date": "2007-05-09",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "ROBERTS",
"authorized_official_first_name": "KATHRYN",
"authorized_official_middle_name": "R",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "651-766-4300"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "MN",
"license": "331964",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "504158900",
"state": "MN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Lakeview Commons",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Maplewood, MN
Sources for this page
- 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.
- 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.