NPIMap

Organization Active NPI

Cherrywood Advanced Living, LLC

  • Assisted Living Facility
  • Sauk Rapids, MN
National Provider Identifier
1821378183
Registry record updated Apr 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
352583 Issued in MN
Legal business name
CHERRYWOOD ADVANCED LIVING, LLC
Practice address
1637 4TH Ave N
Sauk Rapids, MN 56379-4596
Phone
(320) 257-7445
NPI assigned
Aug 18, 2011
Last updated
Apr 24, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
CHERRYWOOD ADVANCED LIVING, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 24, 2017

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

Authorized official

Name
Wendy Hulsebus
Title
Administrator
Phone
(320) 257-7445

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 352583 MN Primary

Addresses

Primary practice location

1637 4TH Ave N
Sauk Rapids, MN 56379-4596

Mailing address

1637 4TH Ave N
Sauk Rapids, MN 56379-4596

Other identifiers 2

IdentifierTypeStateIssuer
353280OtherMNHOUSING WITH SERVICES MDH
376870OtherMNCOMPREHENSIVE HOME CARE

National Provider Directory

National Provider Directory
Tax ID family
Cherrywood Advanced Living LLC10 organizations share this tax ID, including this one
Part of
Cherrywood Advanced Living LLC

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1637 4th Ave N
Sauk Rapids, MN 56379
Phone (320) 257-7445

NPI Registry JSON

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

{
    "created_epoch": "1313625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492992000000",
    "number": "1821378183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1637 4TH AVE N",
            "city": "SAUK RAPIDS",
            "state": "MN",
            "postal_code": "563794596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1637 4TH AVE N",
            "city": "SAUK RAPIDS",
            "state": "MN",
            "postal_code": "563794596",
            "telephone_number": "320-257-7445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHERRYWOOD ADVANCED LIVING, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHERRYWOOD ADVANCED LIVING, LLC",
        "enumeration_date": "2011-08-18",
        "last_updated": "2017-04-24",
        "status": "A",
        "authorized_official_last_name": "HULSEBUS",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "320-257-7445"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MN",
            "license": "352583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOUSING WITH SERVICES MDH",
            "identifier": "353280",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMPREHENSIVE HOME CARE",
            "identifier": "376870",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sauk Rapids, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2017; 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.