Suite Living Senior Care of Forest Lake

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SUITE LIVING SENIOR CARE OF FOREST LAKE

Practice address

19839 Headwaters Blvd North
Forest Lake, MN 55025

Phone

(651) 770-2273

Fax

(651) 666-1975

NPI assigned

Dec 6, 2022

Organization subpart

No

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

Authorized official

Name

Audrey McElwain

Title

Director of Operations

Phone

(651) 770-2273

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

Locations

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

{
    "created_epoch": "1670284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670284800000",
    "number": "1891406336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19839 HEADWATERS BLVD NORTH",
            "city": "FOREST LAKE",
            "state": "MN",
            "postal_code": "55025",
            "telephone_number": "651-770-2273",
            "fax_number": "651-666-1975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19839 HEADWATERS BLVD NORTH",
            "city": "FOREST LAKE",
            "state": "MN",
            "postal_code": "55025",
            "telephone_number": "651-770-2273",
            "fax_number": "651-666-1975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUITE LIVING SENIOR CARE OF FOREST LAKE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-06",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-02",
        "status": "A",
        "authorized_official_last_name": "MCELWAIN",
        "authorized_official_first_name": "AUDREY",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "651-770-2273"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charlotte Louise Stack, R.N., CNS
• William Howard Stackpole, DDS
• Edward J Stec, D.D.S, M.S
• Rodney A Stensrud, DDS
• Connie Renee Stoner
• Summit Orthopedics, LTD
• Sunrise Lakes Mental Health PLLC
• Supervalu Pharmacies Inc
• Susan Hoisington Counseling LLC
• Jennifer Sylvester, SLP

• Assisted Living Facility in Forest Lake, MN
• Providers in Forest 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 Dec 6, 2022; 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.