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NINE MILE CREEK SENIOR LIVING
NPI 1295008787
Assisted Living Facility in Bloomington, MN

Active since February 15, 2012CLIA 24D2008534 · Waiver
2301 VILLAGE LN, BLOOMINGTON, MN 55431(952) 888-0731(952) 884-2191 Get Directions Write a Review

NPPES record last updated: February 15, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Nine Mile Creek Senior Living NPPES

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

NINE MILE CREEK SENIOR LIVING (NPI 1295008787) is a healthcare organization registered as an assisted living facility in Bloomington, Minnesota and active in the NPI registry since February 2012. The organization holds a CLIA Waiver certificate valid through June 10, 2028 and lists Karen Marie Larson, Housing Manager, as its authorized official.

NPPES Registry Identity

NPI1295008787
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameNINE MILE CATERED LIVING
Location Address2301 VILLAGE LNBloomington, MN 55431-5810
Mailing Address2301 Village LnBloomington, MN 55431-5810 · (952) 888-0731 · Fax (952) 884-2191
Phone(952) 888-0731
Fax(952) 884-2191
Organization SubpartNo
Authorized OfficialKaren Marie LarsonHousing Manager · (952) 888-0731
Enumeration DateFebruary 15, 2012
✔ NPI 1295008787 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 · 353396
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.
2301 VILLAGE LN, Bloomington, MN 55431
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Other Names 1

Doing Business AsNine Mile Creek Senior Living

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 24D2008534

Nine Mile Creek Senior Living · Bloomington, MN
Active · expires Jun 10, 2028
CLIA Number24D2008534
Laboratory TypeAssisted Living Facility
Certificate Effective DateJune 11, 2026
Certificate Expiration DateJune 10, 2028
Laboratory DirectorLeanne Obernolte
Laboratory Phone(952) 888-0731
Laboratory LocationNine Mile Creek Senior Living2301 Village Lane, Bloomington, MN 55431
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 Nine Mile Catered Living's NPI number?

The NPI number for Nine Mile Catered Living is 1295008787. It was assigned to this organization in the NPPES registry on February 15, 2012. The provider is doing business as Nine Mile Creek Senior Living.

Where is Nine Mile Catered Living located?

Nine Mile Catered Living is located at 2301 Village Ln, Bloomington, MN 55431. The listed phone number is (952) 888-0731.

What is Nine Mile Catered Living's specialty?

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

Does Nine Mile Catered Living hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D2008534) is associated with this NPI, valid through June 10, 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 Nine Mile Catered Living was last updated on February 15, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.