Clearwater Suites, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

HFID - 21247 Issued in MN

Legal business name

CLEARWATER SUITES, INC.

Practice address

1902 7TH Ave E
Alexandria, MN 56308-2364

Phone

(320) 759-2121

NPI assigned

Jan 2, 2007

Organization subpart

No

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

Authorized official

Name

Mr. John D Patock

Title

Ceo

Phone

(320) 765-8841

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992862650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16176 810TH AVE",
            "city": "SACRED HEART",
            "state": "MN",
            "postal_code": "562851173",
            "telephone_number": "320-765-8841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1902 7TH AVE E",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563082364",
            "telephone_number": "320-759-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEARWATER SUITES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PATOCK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "320-765-8841",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MN",
            "license": "HFID - 21247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Michael Christopherson
• Elizabeth Margaret Clarke, ADT
• Kayla Claseman
• Elizabeth Clasemann
• Michael Clayton, R.PH.
• Deborah Cleveland, FNP,PMHNP
• Diana Clow, LPN
• Heather Lynn Cogger, LPCC, LADC
• Alisha Mae Colby-Timm, CNP
• Ashley Marie Cole, PHARMACY TECHNICIAN

• Assisted Living Facility in Alexandria, MN
• Providers in Alexandria, 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 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.