Long Lake Assisted Living

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

LONG LAKE ASSISTED LIVING

Practice address

345 N Brown Rd
Long Lake, MN 55356

Phone

(953) 473-2527

Fax

(952) 404-9701

NPI assigned

Nov 3, 2006

Last updated

Aug 15, 2007By 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

Mrs. Kati Grengs

Title

Director of Operations

Phone

(952) 473-2527

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187136000000",
    "number": "1851470314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 N BROWN RD",
            "city": "LONG LAKE",
            "state": "MN",
            "postal_code": "55356",
            "telephone_number": "953-473-2527",
            "fax_number": "952-404-9701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 N BROWN RD",
            "city": "LONG LAKE",
            "state": "MN",
            "postal_code": "55356",
            "telephone_number": "953-473-2527",
            "fax_number": "952-404-9701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG LAKE ASSISTED LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2007-08-15",
        "status": "A",
        "authorized_official_last_name": "GRENGS",
        "authorized_official_first_name": "KATI",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "952-473-2527",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Long Lake, MN
• Providers in Long Lake, 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 Aug 15, 2007; 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.