Presbyterian Homes of Bloomington, Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

357334 Issued in MN

Legal business name

PRESBYTERIAN HOMES OF BLOOMINGTON, INC

Practice address

9889 Penn Ave S
Bloomington, MN 55431-2912

Phone

(952) 948-3000

NPI assigned

Feb 14, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Mark Meyer

Title

Cfo

Phone

(651) 631-6120

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• newton manor Other name

Locations

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

{
    "created_epoch": "1392336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394582400000",
    "number": "1649694498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9889 PENN AVE S",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554312912",
            "telephone_number": "952-948-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9889 PENN AVE S",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554312912",
            "telephone_number": "952-948-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESBYTERIAN HOMES OF BLOOMINGTON, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-14",
        "last_updated": "2014-03-12",
        "status": "A",
        "authorized_official_last_name": "MEYER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "651-631-6120",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MN",
            "license": "357334",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMPI",
            "identifier": "M347435200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "newton manor",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Assisted Living Facility in Bloomington, MN
• Providers in Bloomington, MN by specialty
• Assisted Living Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 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.