NPIMap

Organization Active NPI

Estates at St Louis Park LLC

  • Skilled Nursing Facility
  • St Louis Park, MN
National Provider Identifier
1689112153
Registry record updated Feb 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
ESTATES AT ST LOUIS PARK LLC
Practice address
3201 Virginia Ave S
St Louis Park, MN 55426-3624
Phone
(952) 935-0333
NPI assigned
Feb 6, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2017

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

Authorized official

Name
Joshua Legum
Title
Ceo
Phone
(597) 625-8741

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

3201 Virginia Ave S
St Louis Park, MN 55426-3624

Mailing address

638 Southbend Ave
Mankato, MN 56001-2168

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170928000763 MN Part A Provider - Skilled Nursing Facility 3173897238 Practice locations: St Louis Park, MN

Skilled nursing facility certification: CCN 245148

Legal name
ESTATES AT ST LOUIS PARK LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Mar 1, 1968
Last certification
Jun 13, 2024
Beds
145
Ownership / control type
Nonprofit Corporation
Multi-facility organization
Monarch Healthcare Management
Organization structure
LLCProprietary
Incorporated
Dec 30, 2016 in MN
Enrollment address
3201 Virginia Ave S
St Louis Park, MN 55426-3624
Nursing home name
THE ESTATES AT ST LOUIS PARK LLC
Affiliated entity
MONARCH HEALTHCARE MANAGEMENT

Care Compare: Nursing home

Medicare Care Compare
Listed as
The Estates at St Louis Park LLCCCN 245148
Overall star rating
3 of 5
Health inspections
2 of 5
Staffing
5 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Mar 1, 1968
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
145135.2 residents per day on average
Chain
Monarch Healthcare Management45 facilities in the chain
Penalties (3 years)
3Fines totaling $107,139

Processed by Care Compare on Aug 1, 2026.

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
24D0402605Estates at St Louis Park, the3201 Virginia Avenue S, Saint Louis Park, MN 55426Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Spartan Healthcare LLC Organization, Chicago, IL LLC, For-profit 5% Or Greater Direct Ownership Interest Oct 1, 2017 30%
William Stern Individual 5% Or Greater Direct Ownership Interest Oct 1, 2017 20%
Corporate OfficerCfo Oct 1, 2017 20%
Operational/Managerial Control Oct 1, 2017
Marc Halpert Individual 5% Or Greater Indirect Ownership Interest Oct 1, 2017 30%
Corporate DirectorCoo Oct 1, 2017 30%
Jeffrey Arem Individual 5% Or Greater Direct Ownership Interest Oct 1, 2017 6.66%
Monarch Healthcare Operating IV LLC Organization, Mankato, MN LLC, For-profit Operational/Managerial Control Oct 1, 2017 100%
Joshua Legum Individual 5% Or Greater Indirect Ownership Interest Oct 1, 2017 30%
W-2 Managing EmployeeCeo Oct 1, 2017
Yazoma Holdings, LLC Organization, Skokie, IL LLC, For-profit 5% Or Greater Direct Ownership Interest Oct 1, 2017 30%
Noam Jaffa Individual 5% Or Greater Indirect Ownership Interest Oct 1, 2017 6.68%
Nij LLC Organization, St Louis Park, MN LLC, For-profit 5% Or Greater Direct Ownership Interest Oct 1, 2017 6.68%

Facilities with the same owner 44

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 44

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1486339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486339200000",
    "number": "1689112153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "638 SOUTHBEND AVE",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560012168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 VIRGINIA AVE S",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554263624",
            "telephone_number": "952-935-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESTATES AT ST LOUIS PARK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-06",
        "last_updated": "2017-02-06",
        "status": "A",
        "authorized_official_last_name": "LEGUM",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "597-625-8741"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

Verify at the official NPI Registry.