AGATE BAY ASSISTED LIVING LLC
NPI 1205426939
Skilled Nursing Facility in Two Harbors, MN

Active since January 26, 2021CLIA 24D2005334 · Waiver
414 1ST AVE, TWO HARBORS, MN 55616(218) 834-4015 Get Directions Write a Review

NPPES record last updated: January 26, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Agate Bay Assisted Living Llc NPPES

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

AGATE BAY ASSISTED LIVING LLC (NPI 1205426939) is a healthcare organization registered as a skilled nursing facility in Two Harbors, Minnesota and active in the NPI registry since January 2021. The organization holds a CLIA Waiver certificate valid through March 24, 2028 and lists Felisha Johnson, Cfo, as its authorized official.

NPPES Registry Identity

NPI1205426939
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameAGATE BAY ASSISTED LIVING LLC
Location Address414 1ST AVETwo Harbors, MN 55616-1614
Mailing Address414 1st AveTwo Harbors, MN 55616-1614
Organization SubpartNo
Authorized OfficialFelisha JohnsonCfo · (218) 391-4443
Enumeration DateJanuary 26, 2021
NPPES CertifiedJanuary 26, 2021
NPI 1205426939 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
414 1ST AVE, Two Harbors, MN 55616

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 24D2005334

Agate Bay Assisted Living LLC · Two Harbors, MN
Active · expires Mar 24, 2028
CLIA Number24D2005334
Laboratory TypeAssisted Living Facility
Certificate Effective DateMarch 25, 2026
Certificate Expiration DateMarch 24, 2028
Laboratory DirectorSamantha J. Higgs
Laboratory Phone(218) 834-6174
Laboratory LocationAgate Bay Assisted Living LLC414 1st Ave, Two Harbors, MN 55616
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

Assisted Living Facility
414 1ST AVE
TWO HARBORS, MN 55616

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 Agate Bay Assisted Living LLC's NPI number?

The NPI number for Agate Bay Assisted Living LLC is 1205426939. It was assigned to this organization in the NPPES registry on January 26, 2021.

Where is Agate Bay Assisted Living LLC located?

Agate Bay Assisted Living LLC is located at 414 1st Ave, Two Harbors, MN 55616. The listed phone number is (218) 834-4015.

What is Agate Bay Assisted Living LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Agate Bay Assisted Living LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D2005334) is associated with this NPI, valid through March 24, 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 Agate Bay Assisted Living LLC was last updated on January 26, 2021. 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.