WILLOWS BEND SENIOR LIVING LLC
NPI 1780318279
Assisted Living Facility in Fridley, MN
About Willows Bend Senior Living Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
WILLOWS BEND SENIOR LIVING LLC (NPI 1780318279) is a healthcare organization registered as an assisted living facility in Fridley, Minnesota and active in the NPI registry since July 2022. The organization holds a CLIA Waiver certificate valid through May 11, 2028 and lists Katelyn Mrozek, Executive Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
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 24D2259891
Willows Bend Senior Living · Fridley, MNFrequently 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 Willows Bend Senior Living LLC's NPI number?
The NPI number for Willows Bend Senior Living LLC is 1780318279. It was assigned to this organization in the NPPES registry on July 12, 2022.
Where is Willows Bend Senior Living LLC located?
Willows Bend Senior Living LLC is located at 6455 University Ave. NE, Fridley, MN 55432. The listed phone number is (763) 308-2888.
What is Willows Bend Senior Living LLC's specialty?
The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.
Does Willows Bend Senior Living LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 24D2259891) is associated with this NPI, valid through May 11, 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 Willows Bend Senior Living LLC was last updated on July 12, 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.
# Willows Bend Senior Living Llc · NPI 1780318279
Assisted Living Facility organization in Fridley, Minnesota. Organization record, active in the CMS NPPES registry since July 12, 2022.
## Identity
- **NPI:** 1780318279 (Entity type: Organization)
- **Enumerated:** July 12, 2022
- **Primary specialty:** Assisted Living Facility · taxonomy 310400000X
- **Organization subpart:** No
- **Authorized official:** Katelyn Mrozek, EXECUTIVE DIRECTOR
## Practice location
- **Address:** 6455 UNIVERSITY AVE. NE, Fridley, MN 55432
- **Phone:** (763) 308-2888
## Record status
- **NPPES last updated:** July 12, 2022
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1780318279) · Data from the CMS NPPES public registry.