CREEKSIDE COTTAGE
NPI 1063797215
Assisted Living Facility in Coon Rapids, MN
- Organization
- Assisted Living Facility
- CLIA Number: 24D2107007
- CLIA Cert. Type: Assisted Living Facility
- CLIA Exp. Date: 01-04-2028
About CREEKSIDE COTTAGE
This page provides the complete NPI Profile along with additional information for Creekside Cottage, a provider established in Coon Rapids, Minnesota operating as a Assisted Living Facility. The healthcare provider is registered in the NPI registry with number 1063797215 assigned on October 2011. The practitioner's primary taxonomy code is 310400000X with license number 350666 (MN). The provider is registered as an organization and their NPI record was last updated 15 years ago. The provider's is doing business as Creekside Cottage. The authorized official of this NPI record is Ruth Dahl (Director Of Housing With Services)
- NPI
- 1063797215 Verify this NPI
- Provider Legal Name
- MARGARET PLACE LIMITED PARTNERSHIP
- Other Organization Name
- CREEKSIDE COTTAGE
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 1190 117TH AVE NW COON RAPIDS, MN 55448
- Location Phone
- (763) 754-6899
- Mailing Address
- 1555 118TH LN NW COON RAPIDS, MN 55448
- Mailing Phone
- (763) 754-2505
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 10-19-2011
- Last Update Date
- 10-19-2011
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Assisted Living Facility
- Taxonomy Code
- 310400000X
- Type
- Nursing & Custodial Care Facilities
- License No.
- 350666
- License State
- MN
- Taxonomy Description
- A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| A287418300 | MEDICAID (05) | MN |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 24D2107007
- Facility Type
- Assisted Living Facility
- Certificate Effective Date
- January 05, 2026
- Certificate Expiration Date
- January 04, 2028
- Laboratory Director
- WENDY RISCHMILLER
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Creekside Cottage to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for CREEKSIDE COTTAGE
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Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1063797215, enumerated as an "organization" on October 19, 2011.
The provider is located at 1190 117TH AVE NW COON RAPIDS, MN 55448 and the phone number is (763) 754-6899.
Assisted Living Facility with taxonomy code 310400000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
