AUTUMN GLEN SENIOR LIVING
NPI 1104323773
Assisted Living Facility in Coon Rapids, MN
About Autumn Glen Senior Living NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
AUTUMN GLEN SENIOR LIVING (NPI 1104323773) is a healthcare organization registered as an assisted living facility in Coon Rapids, Minnesota and active in the NPI registry since April 2018. The organization holds a CLIA Waiver certificate valid through May 21, 2028 and lists James A Weichert, Director Of General Partner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 24D2148947
New Western Manor Company Limited Partnership Dba Autumn Glen Senior Living · Coon Rapids, MNOther Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
COON RAPIDS, MN 55433
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is New Western Manor Company Limited Partnership's NPI number?
The NPI number for New Western Manor Company Limited Partnership is 1104323773. It was assigned to this organization in the NPPES registry on April 10, 2018. The provider is doing business as Autumn Glen Senior Living.
Where is New Western Manor Company Limited Partnership located?
New Western Manor Company Limited Partnership is located at 3715 Coon Rapids Blvd NW, Coon Rapids, MN 55433. The listed phone number is (763) 772-4492.
What is New Western Manor Company Limited Partnership's specialty?
The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.
Does New Western Manor Company Limited Partnership hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 24D2148947) is associated with this NPI, valid through May 21, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for New Western Manor Company Limited Partnership was last updated on June 19, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Autumn Glen Senior Living · NPI 1104323773
Assisted Living Facility organization in Coon Rapids, Minnesota. Organization record, active in the CMS NPPES registry since April 10, 2018.
## Identity
- **NPI:** 1104323773 (Entity type: Organization)
- **Enumerated:** April 10, 2018
- **Primary specialty:** Assisted Living Facility · taxonomy 310400000X
- **Legal business name:** New Western Manor Company Limited Partnership
- **Organization subpart:** No
- **Authorized official:** James Weichert, DIRECTOR OF GENERAL PARTNER
## Practice location
- **Address:** 3715 COON RAPIDS BLVD NW, Coon Rapids, MN 55433
- **Phone:** (763) 772-4492
## Record status
- **NPPES last updated:** June 19, 2018
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1104323773) · Data from the CMS NPPES public registry.