Community Assisted Living, Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

COMMUNITY ASSISTED LIVING, INC

Practice address

16670 Franklin TRL SE
Suite 120a
Prior Lake, MN 55372-2924

Phone

(952) 440-3955

Fax

(952) 440-3956

NPI assigned

Sep 26, 2006

Organization subpart

No

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

Authorized official

Name

Donna Novak

Title

Ceo

Phone

(952) 440-3955

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790886331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16670 FRANKLIN TRL SE",
            "address_2": "SUITE 120A",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553722924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16670 FRANKLIN TRL SE",
            "address_2": "SUITE 120A",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553722924",
            "telephone_number": "952-440-3955",
            "fax_number": "952-440-3956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY ASSISTED LIVING, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NOVAK",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "952-440-3955"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "4989251",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Prior Lake, MN
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.