Aviv Health Care, Inc.

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

328130 Issued in MN

Legal business name

AVIV HEALTH CARE, INC.

Practice address

501 2ND St SE
Osseo, MN 55369-1603

Phone

(763) 425-3939

Fax

(763) 424-2777

NPI assigned

Sep 9, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Tony Pasell

Title

Comptroller

Phone

(952) 259-5222

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• BERKSHIRE RESIDENCE Doing business as

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

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891789434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4509 MINNETONKA BLVD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554164027",
            "telephone_number": "952-259-5224",
            "fax_number": "952-920-5207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 2ND ST SE",
            "city": "OSSEO",
            "state": "MN",
            "postal_code": "553691603",
            "telephone_number": "763-425-3939",
            "fax_number": "763-424-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVIV HEALTH CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PASELL",
        "authorized_official_first_name": "TONY",
        "authorized_official_title_or_position": "COMPTROLLER",
        "authorized_official_telephone_number": "952-259-5222",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "MN",
            "license": "328130",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "7122708",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "9456BE",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "NH0003",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BERKSHIRE RESIDENCE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rebecca J Adams, MA, LMFT
• Samantha Josephine Anderson
• Nicole Andrea Arduino
• Kathryn Bailey, DC
• Jeffrey L Bakke, M.D.
• BCSP Holdings
• Courtney Bennett, CCC-SLP
• Jennifer Marie Berger, PA-C

• All providers in Osseo, MN
• Nursing Facility/Intermediate Care Facility in Minnesota

• 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.