CHAMPLIN SHORES
NPI 1194845107
Assisted Living Facility in Champlin, MN

Q: What is Champlin Shores LLC's NPI number?

The NPI number for Champlin Shores LLC is 1194845107. It was assigned to this organization in the NPPES registry on March 31, 2007. The provider is doing business as Champlin Shores.

Q: What is Champlin Shores LLC's specialty?

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

Active since March 31, 2007

119 HAYDEN LAKE RD E, CHAMPLIN, MN 55316(763) 712-0118 Get Directions Write a Review

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

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About Champlin Shores NPPES

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

CHAMPLIN SHORES (NPI 1194845107) is a healthcare organization registered as an assisted living facility in Champlin, Minnesota and active in the NPI registry since March 2007. The organization lists Jon Harder, Manager, as its authorized official.

NPPES Registry Identity

NPI1194845107

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NameCHAMPLIN SHORES LLC

Location Address119 HAYDEN LAKE RD EChamplin, MN 55316-1547

Mailing Address3723 Fairview Industrial Dr Se Ste 270Salem, OR 97302-4975 · (503) 485-4600

Phone(763) 712-0118

Organization SubpartNo

Authorized OfficialJon HarderManager · (503) 485-4600

Enumeration DateMarch 31, 2007

Last NPPES UpdateAugust 22, 2020

✔ NPI 1194845107 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities

Taxonomy Code310400000X

License✔ Licensed in MN · 333870

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.

119 HAYDEN LAKE RD E, Champlin, MN 55316

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Other Names 1

Doing Business AsChamplin Shores

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.

LCS CHAMPLIN LLC

Assisted Living Facility

119 HAYDEN LAKE RD E
CHAMPLIN, MN 55316

Hennepin County (763) 712-0118

EMERITUS CORPORATION

Assisted Living Facility

119 HAYDEN LAKE RD E
CHAMPLIN, MN 55316

Hennepin County (763) 712-0118

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 Champlin Shores LLC's NPI number?

The NPI number for Champlin Shores LLC is 1194845107. It was assigned to this organization in the NPPES registry on March 31, 2007. The provider is doing business as Champlin Shores.

Where is Champlin Shores LLC located?

Champlin Shores LLC is located at 119 Hayden Lake Rd E, Champlin, MN 55316. The listed phone number is (763) 712-0118.

What is Champlin Shores 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 Champlin Shores 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.