KTJ 212, LLC
NPI 1104480714
Assisted Living Facility in Excelsior, MN

Q: What is Ktj 212, LLC's NPI number?

The NPI number for Ktj 212, LLC is 1104480714. It was assigned to this organization in the NPPES registry on April 29, 2019. The provider is doing business as Shorewood Landing Senior Living.

Q: What is Ktj 212, LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Q: When was this NPI record last updated?

The NPPES record for Ktj 212, LLC was last updated on April 29, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.

Active since April 29, 2019

6000 CHASKA RD, EXCELSIOR, MN 55331(952) 401-7444 Get Directions Write a Review

NPPES record last updated: April 29, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Ktj 212, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KTJ 212, LLC (NPI 1104480714), doing business as Shorewood Landing Senior Living, is a healthcare organization registered as an assisted living facility in Excelsior, Minnesota and active in the NPI registry since April 2019. The organization lists Lisa Miskulin, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1104480714

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NameKTJ 212, LLC

Location Address6000 CHASKA RDExcelsior, MN 55331-3173

Mailing Address6000 Chaska RdExcelsior, MN 55331-3173 · (952) 401-7444

Phone(952) 401-7444

Organization SubpartNo

Authorized OfficialLisa MiskulinExecutive Director · (952) 401-7444

Enumeration DateApril 29, 2019

✔ NPI 1104480714 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities

Taxonomy Code310400000X

Definition

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.

6000 CHASKA RD, Excelsior, MN 55331

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Other Names 1

Doing Business AsShorewood Landing Senior Living

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PHS SHOREWOOD LLC

Assisted Living Facility

6000 CHASKA RD
SHOREWOOD, MN 55331

Hennepin County (952) 401-7444

OPTAGE INC

Clinic/Center (Rehabilitation)

6000 CHASKA RD
SHOREWOOD, MN 55331

Hennepin County (651) 631-6570

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 Ktj 212, LLC's NPI number?

The NPI number for Ktj 212, LLC is 1104480714. It was assigned to this organization in the NPPES registry on April 29, 2019. The provider is doing business as Shorewood Landing Senior Living.

Where is Ktj 212, LLC located?

Ktj 212, LLC is located at 6000 Chaska Rd, Excelsior, MN 55331. The listed phone number is (952) 401-7444.

What is Ktj 212, LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

When was this NPI record last updated?

The NPPES record for Ktj 212, LLC was last updated on April 29, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.