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THE LODGE OF MOUNTAIN LAKE
NPI 1750622908
Assisted Living Facility in Mountain Lake, MN

Active since March 13, 2013CLIA 24D1016198 · Waiver
603 7TH AVE, MOUNTAIN LAKE, MN 56159(507) 427-2465 Get Directions Write a Review

NPPES record last updated: April 13, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 13, 2022, Mar 2, 2016 (2 updates tracked since 2016).

About The Lodge Of Mountain Lake NPPES

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

THE LODGE OF MOUNTAIN LAKE (NPI 1750622908) is a healthcare organization registered as an assisted living facility in Mountain Lake, Minnesota and active in the NPI registry since March 2013. The organization holds a CLIA Waiver certificate valid through August 21, 2027 and lists David C Pokorney, Treasurer, as its authorized official.

NPPES Registry Identity

NPI1750622908
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameCOMMUNITY ASSET FOUNDATION, LLC
Location Address603 7TH AVEMountain Lake, MN 56159-1333
Mailing Address745 Basinger Memorial DrMountain Lake, MN 56159-1312
Phone(507) 427-2465
Organization SubpartNo
Authorized OfficialDavid C PokorneyTreasurer · (612) 703-5709
Enumeration DateMarch 13, 2013
Last NPPES UpdateApril 13, 20222 updates tracked since enumeration
NPPES CertifiedApril 13, 2022
✔ NPI 1750622908 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 · 29275
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.
603 7TH AVE, Mountain Lake, MN 56159
Open in Google Maps ↗

Other Names 1

Doing Business AsThe Lodge Of Mountain Lake

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 24D1016198

The Lodge Of Mountain Lake · Mountain Lake, MN
Active · expires Aug 21, 2027
CLIA Number24D1016198
Laboratory TypeAssisted Living Facility
Certificate Effective DateAugust 22, 2025
Certificate Expiration DateAugust 21, 2027
Laboratory DirectorJada Voshage Hampel
Laboratory Phone(507) 427-2465
Laboratory LocationThe Lodge Of Mountain Lake603 7th Avenue, Mountain Lake, MN 56159
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 Community Asset Foundation, LLC's NPI number?

The NPI number for Community Asset Foundation, LLC is 1750622908. It was assigned to this organization in the NPPES registry on March 13, 2013. The provider is doing business as The Lodge Of Mountain Lake.

Where is Community Asset Foundation, LLC located?

Community Asset Foundation, LLC is located at 603 7th Ave, Mountain Lake, MN 56159. The listed phone number is (507) 427-2465.

What is Community Asset Foundation, LLC's specialty?

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

Does Community Asset Foundation, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D1016198) is associated with this NPI, valid through August 21, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Community Asset Foundation, LLC was last updated on April 13, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.