Sholom Community Alliance, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SHOLOM COMMUNITY ALLIANCE, LLC

Practice address

3610 Phillips Pkwy
St Louis Park, MN 55426-3765

Phone

(952) 908-1700

NPI assigned

May 14, 2019

Organization subpart

No

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

Authorized official

Name

Douglas Wyckoff

Title

Controller

Phone

(952) 939-1637

Specialties & licenses 1

Addresses

Other names 1

• Roitenberg Family Assisted Living Residence Doing business as

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": "1557792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557792000000",
    "number": "1972169159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3610 PHILLIPS PKWY",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554263765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3610 PHILLIPS PKWY",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554263765",
            "telephone_number": "952-908-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOLOM COMMUNITY ALLIANCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-14",
        "last_updated": "2019-05-14",
        "status": "A",
        "authorized_official_last_name": "WYCKOFF",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "952-939-1637"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Roitenberg Family Assisted Living Residence",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Margaret Mary Shipitalo, OD, MS
• Omri Shochatovitz
• Sholom Community Alliance Home Health Care
• Sholom Community Alliance Home Health Care
• Sholom Community Alliance Home Health Care
• Sholom Home West Inc
• Joan Marie Shopbell, RD
• Benjamin Shoults
• Sidney G Showers
• Judith R Shragg, MS, CCC, SLP

• Assisted Living Facility in St Louis Park, MN
• Providers in St Louis Park, 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 May 14, 2019; 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.