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SPRING GROVE ASSISTED LIVING LLC
NPI 1184715971
Assisted Living Facility in Spring Grove, MN

Active since September 27, 2006CLIA 24D1042979 · Waiver
130 5TH AVE SE, SPRING GROVE, MN 55974(507) 498-4000(507) 498-4001 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Spring Grove Assisted Living Llc NPPES

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

SPRING GROVE ASSISTED LIVING LLC (NPI 1184715971) is a healthcare organization registered as an assisted living facility in Spring Grove, Minnesota and active in the NPI registry since September 2006. The organization holds a CLIA Waiver certificate valid through July 12, 2027 and lists Nicole Kimmerle, Director Of Nursing Services, as its authorized official.

NPPES Registry Identity

NPI1184715971
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameSPRING GROVE ASSISTED LIVING LLC
Location Address130 5TH AVE SESpring Grove, MN 55974-1324
Mailing Address130 5th Ave SeSpring Grove, MN 55974-1324 · (507) 498-4000 · Fax (507) 498-4001
Phone(507) 498-4000
Fax(507) 498-4001
Organization SubpartNo
Authorized OfficialNicole KimmerleDirector Of Nursing Services · (507) 498-4000
Enumeration DateSeptember 27, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1184715971 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.
130 5TH AVE SE, Spring Grove, MN 55974
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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 24D1042979

Spring Grove Assisted Living · Spring Grove, MN
Active · expires Jul 12, 2027
CLIA Number24D1042979
Laboratory TypeAssisted Living Facility
Certificate Effective DateJuly 13, 2025
Certificate Expiration DateJuly 12, 2027
Laboratory DirectorNikki Kimmerle
Laboratory Phone(507) 498-4000
Laboratory LocationSpring Grove Assisted Living130 5th Ave SE, Spring Grove, MN 55974
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Spring Grove Assisted Living LLC's NPI number?

The NPI number for Spring Grove Assisted Living LLC is 1184715971. It was assigned to this organization in the NPPES registry on September 27, 2006.

Where is Spring Grove Assisted Living LLC located?

Spring Grove Assisted Living LLC is located at 130 5th Ave SE, Spring Grove, MN 55974. The listed phone number is (507) 498-4000.

What is Spring Grove Assisted Living LLC's specialty?

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

Does Spring Grove Assisted Living LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D1042979) is associated with this NPI, valid through July 12, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Spring Grove Assisted Living LLC was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.