MARY T ASSOCIATES
NPI 1447390570
Intermediate Care Facility, Intellectual Disabilities in Coon Rapids, MN

Active since February 07, 2007CLIA 24D0946872 · Waiver
1555 118TH LN NW, COON RAPIDS, MN 55448(763) 862-5436(763) 754-0332 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mary T Associates NPPES

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

MARY T ASSOCIATES (NPI 1447390570) is a healthcare organization registered as an intermediate care facility, intellectual disabilities in Coon Rapids, Minnesota and active in the NPI registry since February 2007. The organization holds a CLIA Waiver certificate valid through June 3, 2028 and lists Connie Winbauer, Controller, as its authorized official.

NPPES Registry Identity

NPI1447390570
Entity TypeOrganization
Primary Taxonomy315P00000X
Legal Business NameCAMILIA ROSE GROUP HOME
Location Address1555 118TH LN NWCoon Rapids, MN 55448-7579
Mailing Address1555 118th Ln NwCoon Rapids, MN 55448-7579 · (763) 862-5436 · Fax (763) 754-0332
Fax(763) 754-0332
Organization SubpartNo
Authorized OfficialConnie WinbauerController · (763) 862-5436
Enumeration DateFebruary 7, 2007
Last NPPES UpdateAugust 22, 2020
NPI 1447390570 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyIntermediate Care Facility, Intellectual DisabilitiesNursing & Custodial Care Facilities
Taxonomy Code315P00000X
License Licensed in MN · 1075259
Definition

An intermediate care facility providing services for individuals with intellectual disabilities.

1555 118TH LN NW, Coon Rapids, MN 55448

Other Names 1

Other NameMary T Associates

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 24D0946872

Camilia Rose Group Home · Coon Rapids, MN
Active · expires Jun 3, 2028
CLIA Number24D0946872
Laboratory TypeIntermediate Care Facility For Mentally Retarded
Certificate Effective DateJune 4, 2026
Certificate Expiration DateJune 3, 2028
Laboratory DirectorLisa Baum
Laboratory Phone(763) 592-9414
Laboratory LocationCamilia Rose Group Home11820 Xeon Boulevard Northwest, Coon Rapids, MN 55448
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

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

Hospice Care, Community Based
1555 118TH LN NW
COON RAPIDS, MN 55448
Assisted Living Facility
1555 118TH LN NW
COON RAPIDS, MN 55448
Intermediate Care Facility, Intellectual Disabilities
1555 118TH LN NW
MINNEAPOLIS, MN 55448
Home Health
1555 118TH LN NW
COON RAPIDS, MN 55448

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 Camilia Rose Group Home's NPI number?

The NPI number for Camilia Rose Group Home is 1447390570. It was assigned to this organization in the NPPES registry on February 7, 2007. The provider is also known as Mary T Associates.

Where is Camilia Rose Group Home located?

Camilia Rose Group Home is located at 1555 118th Ln NW, Coon Rapids, MN 55448. The listed phone number is (763) 862-5436.

What is Camilia Rose Group Home's specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

Does Camilia Rose Group Home hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D0946872) is associated with this NPI, valid through June 3, 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 Camilia Rose Group Home was last updated on August 22, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.