HAZEL SENIOR LIVING
NPI 1770106205
Assisted Living Facility in Saint Paul, MN

NPI Status: Active since May 19, 2020

Contact Information

1109 HAZEL ST N
SAINT PAUL, MN
ZIP 55119
Phone: (651) 600-4403

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  • Organization
  • Assisted Living Facility
  • CLIA Number: 24D2184144
  • CLIA Cert. Type: Assisted Living Facility
  • CLIA Exp. Date: 05-14-2026

About HAZEL SENIOR LIVING

This page provides the complete NPI Profile along with additional information for Hazel Senior Living, a provider established in Saint Paul, Minnesota operating as a Assisted Living Facility. The healthcare provider is registered in the NPI registry with number 1770106205 assigned on May 2020. The practitioner's primary taxonomy code is 310400000X. The provider is registered as an organization and their NPI record was last updated 6 years ago. The authorized official of this NPI record is Tong Vang (Operations Manager)

NPI
1770106205
Provider Name
HAZEL SENIOR LIVING
Entity Type
Organization
Location Address
1109 HAZEL ST N SAINT PAUL, MN 55119
Location Phone
(651) 600-4403
Mailing Address
1109 HAZEL ST N SAINT PAUL, MN 55119
Mailing Phone
(651) 600-4403
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
05-19-2020
Last Update Date
05-19-2020
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Assisted Living Facility

Taxonomy Code
310400000X
Type
Nursing & Custodial Care Facilities
Taxonomy Description
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.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

TONG VANG

Authorized Official Title
OPERATIONS MANAGER
Authorized Official Phone
(651) 600-4403

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
24D2184144
Facility Type
Assisted Living Facility
Certificate Effective Date
May 15, 2024
Certificate Expiration Date
May 14, 2026
Laboratory Director
MAI S. VANG
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Hazel Senior Living to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1770106205, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 45. The final step is to find the difference between that total and the next multiple of ten (50 - 45 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
7
Unchanged
Pos 3
7
Doubled → 14 → 1 + 4
Pos 4
0
Unchanged
Pos 5
1
Doubled → 2
Pos 6
0
Unchanged
Pos 7
6
Doubled → 12 → 1 + 2
Pos 8
2
Unchanged
Pos 9
0
Doubled → 0
Check
5
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 7 → 14 → 5 1 → 2 6 → 12 → 3 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 7 + 1 + 4 + 0 + 2 + 0 + 1 + 2 + 2 + 0 + 24 = 45

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 45 is 50. The difference is the calculated check digit.

50 - 45 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1770106205.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1770106205, enumerated as an "organization" on May 19, 2020.

The provider is located at 1109 HAZEL ST N SAINT PAUL, MN 55119 and the phone number is (651) 600-4403.

Assisted Living Facility with taxonomy code 310400000X.