Countryview Assisted Living LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

COUNTRYVIEW ASSISTED LIVING LLC

Practice address

1000 1St St SE
Fairfax, MN 55332-9795

Phone

(507) 430-0444

NPI assigned

May 17, 2022

Organization subpart

No

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

Authorized official

Name

Helen Evelyn Reynolds

Title

Member

Phone

(507) 637-0819

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1652745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652745600000",
    "number": "1760129191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 1ST ST SE",
            "city": "FAIRFAX",
            "state": "MN",
            "postal_code": "553329795",
            "telephone_number": "507-430-0444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 1ST ST SE",
            "city": "FAIRFAX",
            "state": "MN",
            "postal_code": "553329795",
            "telephone_number": "507-430-0444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRYVIEW ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-17",
        "last_updated": "2022-05-17",
        "certification_date": "2022-05-17",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "HELEN",
        "authorized_official_middle_name": "EVELYN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "507-637-0819"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Charles Bengtson, D.D.S.
• Deidre Campen, MS, LPCC
• City of Fairfax
• City of Sleepy Eye
• Tiana Jean Clobes
• Angela Ebel, LGSW
• Fairfax Community Home Health
• Fairfax Community Home Inc
• Fairfax Medical Clinic PA
• Thomas Frederick Gilles, M.D,

• Assisted Living Facility in Fairfax, MN
• Providers in Fairfax, 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 17, 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.