Park Lane Estates of Preston, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

PARK LANE ESTATES OF PRESTON, LLC

Practice address

111 Fillmore Place SE
Preston, MN 55965

Phone

(507) 765-9986

NPI assigned

Jan 9, 2024

Organization subpart

No

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

Authorized official

Name

Abdullahi Omar

Title

President

Phone

(612) 404-6892

Specialties & licenses 1

Addresses

Other names 1

• Park Lane Estates Doing business as

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

{
    "created_epoch": "1704758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704758400000",
    "number": "1942071972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2277 HIGHWAY 36 W STE 300",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551133830",
            "telephone_number": "612-404-6892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 FILLMORE PLACE SE",
            "city": "PRESTON",
            "state": "MN",
            "postal_code": "55965",
            "telephone_number": "507-765-9986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK LANE ESTATES OF PRESTON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-09",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-08",
        "status": "A",
        "authorized_official_last_name": "OMAR",
        "authorized_official_first_name": "ABDULLAHI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "612-404-6892"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Park Lane Estates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tami Karban
• Dale E Loeffler
• McBe Company
• Moving on Recovery and Education
• Park Lane Estates Assisted Living
• Susan Renee Pikula, MS, LPCC
• Preston Eye Clinic LLC
• Sarah Sandvik
• Serenity Family Chiropractic
• Spring Valley Dental

• All providers in Preston, MN
• Assisted Living Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2024; 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.