CRYSTAL BROOK SENIOR LIVING
NPI 1659866630
Assisted Living Facility in Park Rapids, MN
About Crystal Brook Senior Living NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CRYSTAL BROOK SENIOR LIVING (NPI 1659866630) is a healthcare organization registered as an assisted living facility in Park Rapids, Minnesota and active in the NPI registry since June 2018. The organization holds a CLIA Waiver certificate valid through November 6, 2026 and lists Marnie Marie Gugisberg, Cfo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
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 24D2157550
Crystal Brook Senior Living · Park Rapids, MNOther Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Ki Senior Living Of Park Rapids, LLC's NPI number?
The NPI number for Ki Senior Living Of Park Rapids, LLC is 1659866630. It was assigned to this organization in the NPPES registry on June 22, 2018. The provider is doing business as Crystal Brook Senior Living.
Where is Ki Senior Living Of Park Rapids, LLC located?
Ki Senior Living Of Park Rapids, LLC is located at 1006 Crocus Hill St E, Park Rapids, MN 56470. The listed phone number is (218) 699-3605.
What is Ki Senior Living Of Park Rapids, LLC's specialty?
The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.
Does Ki Senior Living Of Park Rapids, LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 24D2157550) is associated with this NPI, valid through November 6, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Ki Senior Living Of Park Rapids, LLC was last updated on June 22, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.
# Crystal Brook Senior Living · NPI 1659866630
Assisted Living Facility organization in Park Rapids, Minnesota. Organization record, active in the CMS NPPES registry since June 22, 2018.
## Identity
- **NPI:** 1659866630 (Entity type: Organization)
- **Enumerated:** June 22, 2018
- **Primary specialty:** Assisted Living Facility · taxonomy 310400000X
- **Legal business name:** Ki Senior Living Of Park Rapids, Llc
- **Organization subpart:** No
- **Authorized official:** Marnie Gugisberg, CFO
## Practice location
- **Address:** 1006 CROCUS HILL ST E, Park Rapids, MN 56470-5419
- **Phone:** (218) 699-3605
## Record status
- **NPPES last updated:** June 22, 2018
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1659866630) · Data from the CMS NPPES public registry.