Arbor Lakes Senior Living II LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

ARBOR LAKES SENIOR LIVING II LLC

Doing business as

Willows of Arbor Lakes

Practice address

11955 80TH Ave N
Maple Grove, MN 55369-4755

Phone

(651) 492-6535

NPI assigned

May 26, 2021

Last updated

May 26, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kelly Myers

Title

Vice President of Operations

Phone

(651) 492-6535

Specialties & licenses 1

Addresses

Other names 1

• Willows of Arbor Lakes Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1621987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621987200000",
    "number": "1740855287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "945 SIBLEY MEMORIAL HWY",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551182737",
            "telephone_number": "651-492-6535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11955 80TH AVE N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694755",
            "telephone_number": "651-492-6535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARBOR LAKES SENIOR LIVING II LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-26",
        "last_updated": "2021-05-26",
        "certification_date": "2021-05-26",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "VICE PRESIDENT OF OPERATIONS",
        "authorized_official_telephone_number": "651-492-6535"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Willows of Arbor Lakes",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Maple Grove, MN
• Providers in Maple Grove, 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 26, 2021; 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.

Verify at the official NPI Registry.