SNH Viking Tenant LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SNH VIKING TENANT LLC

Doing business as

The Wellstead of Rogers

Practice address

20600 S Diamond Lake Rd
Rogers, MN 55374-4515

Phone

(763) 428-1981

Fax

(463) 428-3792

NPI assigned

Aug 23, 2019

Organization subpart

Yes

Parent organization

SNH VIKING TENANT LLCAs reported in NPPES

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

Authorized official

Name

Jennifer F. Mintzer

Title

President & Chief Operating Officer

Phone

(617) 796-8350

Specialties & licenses 1

Addresses

Other names 1

• The Wellstead of Rogers Doing business as

Part of

SNH Viking Tenant LLC

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

{
    "created_epoch": "1566518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588550400000",
    "number": "1740837749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 WASHINGTON ST STE 300",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024581634",
            "telephone_number": "617-796-8350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20600 S DIAMOND LAKE RD",
            "city": "ROGERS",
            "state": "MN",
            "postal_code": "553744515",
            "telephone_number": "763-428-1981",
            "fax_number": "463-428-3792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SNH VIKING TENANT LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SNH VIKING TENANT LLC",
        "enumeration_date": "2019-08-23",
        "last_updated": "2020-05-04",
        "certification_date": "2020-05-04",
        "status": "A",
        "authorized_official_last_name": "MINTZER",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "PRESIDENT & CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "617-796-8350"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Wellstead of Rogers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sifana Telehealth & Wellness LLC
• Jodi Lynn Sims, MA LMFT
• Jeffrey Kent Sletten, MPT
• Jeffrey Alan Smith, D.D.S.
• Kevin Jeffery Smith, LMFT
• Sarah Marie Soltys Larson, D.D.S.
• Spedale Optics LLC
• Reilly Springman
• Jessica Stauber
• Mark Jeffrey Steenerson, DC

• Assisted Living Facility in Rogers, MN
• Providers in Rogers, 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 4, 2020; 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.