SELECT SENIOR LIVING OF COON RAPIDS, LLC
NPI 1720252836
Assisted Living Facility in Coon Rapids, MN

Q: What is Select Senior Living Of Coon Rapids, LLC's specialty?

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

Active since April 18, 2008CLIA 24D1084958 · Waiver

11350 MARTIN ST NW, COON RAPIDS, MN 55433(763) 767-1127(651) 455-0267 Get Directions Write a Review

NPPES record last updated: April 18, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Select Senior Living Of Coon Rapids, Llc NPPES

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

SELECT SENIOR LIVING OF COON RAPIDS, LLC (NPI 1720252836) is a healthcare organization registered as an assisted living facility in Coon Rapids, Minnesota and active in the NPI registry since April 2008. The organization holds a CLIA Waiver certificate valid through June 5, 2028 and lists Kelly J Myers, Residence Director, as its authorized official.

NPPES Registry Identity

NPI1720252836

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NameSELECT SENIOR LIVING OF COON RAPIDS, LLC

Location Address11350 MARTIN ST NWCoon Rapids, MN 55433-3988

Mailing Address11350 Martin St NwCoon Rapids, MN 55433-3988 · (763) 767-1127 · Fax (651) 455-0267

Phone(763) 767-1127

Fax(651) 455-0267

Organization SubpartNo

Authorized OfficialKelly J MyersResidence Director · (651) 492-6535

Enumeration DateApril 18, 2008

✔ NPI 1720252836 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 · 339176

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.

11350 MARTIN ST NW, Coon Rapids, MN 55433

Open in Google Maps ↗

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 24D1084958

Select Senior Living Of Coon Rapids · Coon Rapids, MN

Active · expires Jun 5, 2028

CLIA Number24D1084958

Laboratory TypeHome Health Agency

Certificate Effective DateJune 6, 2026

Certificate Expiration DateJune 5, 2028

Laboratory DirectorLisa Lemieux

Laboratory Phone(763) 767-1127

Laboratory LocationSelect Senior Living Of Coon Rapids11350 Martin Street NW, Coon Rapids, MN 55433

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 Select Senior Living Of Coon Rapids, LLC's NPI number?

The NPI number for Select Senior Living Of Coon Rapids, LLC is 1720252836. It was assigned to this organization in the NPPES registry on April 18, 2008.

Where is Select Senior Living Of Coon Rapids, LLC located?

Select Senior Living Of Coon Rapids, LLC is located at 11350 Martin St NW, Coon Rapids, MN 55433. The listed phone number is (763) 767-1127.

What is Select Senior Living Of Coon Rapids, LLC's specialty?

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

Does Select Senior Living Of Coon Rapids, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D1084958) is associated with this NPI, valid through June 5, 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 Select Senior Living Of Coon Rapids, LLC was last updated on April 18, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.