Kindred Supports LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

KINDRED SUPPORTS LLC

Practice address

5554 Woodside Rd SE
Prior Lake, MN 55372-2044

Phone

(612) 810-9796

NPI assigned

May 25, 2022

Organization subpart

No

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

Authorized official

Name

Anthony Gjorvad

Title

Owner

Phone

(612) 812-9786

Specialties & licenses 1

Addresses

Other names 2

• Kindred Supports Doing business as
• Touching Lives Community Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1653436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653436800000",
    "number": "1669110953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4220 157TH ST W",
            "city": "ROSEMOUNT",
            "state": "MN",
            "postal_code": "550684600",
            "telephone_number": "612-812-9786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5554 WOODSIDE RD SE",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553722044",
            "telephone_number": "612-810-9796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINDRED SUPPORTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-25",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A",
        "authorized_official_last_name": "GJORVAD",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-812-9786"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "anthonyg@kindredsupports.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5554 Woodside Rd SE",
            "city": "Prior Lake",
            "state": "MN",
            "country_code": "US",
            "postal_code": "553722044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Kindred Supports",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Touching Lives Community",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dana Kelly, RN,C
• Kes Chiropractic, PA
• Sharon K Kettler, RDH
• Keystone Communities of Prior Lake
• Kid Talk Inc
• Marcia Kirk, L.AC.
• Muntas Kiyton
• Melissa Kloss, PSY.D.
• Christopher Barnett Knudsvig
• Inna Koval, RN

• Assisted Living Facility in Prior Lake, MN
• Providers in Prior Lake, 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 May 25, 2022; 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.