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BLAINE WP II, LLC
NPI 1871989806
Assisted Living Facility in Blaine, MN

Active since April 07, 2015CLIA 24D2097108 · Waiver
12402 JAMESTOWN STREET NE, BLAINE, MN 55449(651) 287-0265(651) 287-0266 Get Directions Write a Review

NPPES record last updated: April 7, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Blaine Wp Ii, Llc NPPES

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

BLAINE WP II, LLC (NPI 1871989806) is a healthcare organization registered as an assisted living facility in Blaine, Minnesota and active in the NPI registry since April 2015. The organization holds a CLIA Waiver certificate valid through June 8, 2027 and lists Sarah Pauley, Business Manager, as its authorized official.

NPPES Registry Identity

NPI1871989806
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameBLAINE WP II, LLC
Location Address12402 JAMESTOWN STREET NEBlaine, MN 55449
Mailing Address750 Main St, Suite 200Mendota Heights, MN 55118-3764 · (651) 287-0265 · Fax (651) 287-0266
Phone(651) 287-0265
Fax(651) 287-0266
Organization SubpartNo
Authorized OfficialSarah PauleyBusiness Manager · (651) 287-0265
Enumeration DateApril 7, 2015
✔ NPI 1871989806 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
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.
12402 JAMESTOWN STREET NE, Blaine, MN 55449
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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 24D2097108

Blaine Wp II, LLC · Blaine, MN
Active · expires Jun 8, 2027
CLIA Number24D2097108
Laboratory TypeAssisted Living Facility
Certificate Effective DateJune 9, 2025
Certificate Expiration DateJune 8, 2027
Laboratory DirectorBrittany Rands
Laboratory Phone(763) 205-4163
Laboratory LocationBlaine Wp II, LLC12402 Jamestown Street NE, Blaine, MN 55449
CLIA data matches this NPI record on: Address Name
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 Blaine Wp II, LLC's NPI number?

The NPI number for Blaine Wp II, LLC is 1871989806. It was assigned to this organization in the NPPES registry on April 7, 2015.

Where is Blaine Wp II, LLC located?

Blaine Wp II, LLC is located at 12402 Jamestown Street NE, Blaine, MN 55449. The listed phone number is (651) 287-0265.

What is Blaine Wp II, LLC's specialty?

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

Does Blaine Wp II, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D2097108) is associated with this NPI, valid through June 8, 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 Blaine Wp II, LLC was last updated on April 7, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.