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FARGO MAPLE VIEW LLC
NPI 1922605310
Alzheimer Center (Dementia Center) in Fargo, ND

Active since October 08, 2020CLIA 35D2079940 · Waiver
4552 36TH AVE S, FARGO, ND 58104(701) 478-8655 Get Directions Write a Review

NPPES record last updated: October 8, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Fargo Maple View Llc NPPES

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

FARGO MAPLE VIEW LLC (NPI 1922605310), doing business as Maple View Fargo, is a healthcare organization registered as an alzheimer center (dementia center) in Fargo, North Dakota and active in the NPI registry since October 2020. The organization holds a CLIA Waiver certificate valid through June 25, 2028 and lists Chad Michael Olson, Cfo, as its authorized official.

NPPES Registry Identity

NPI1922605310
Entity TypeOrganization
Primary Taxonomy311500000X
Legal Business NameFARGO MAPLE VIEW LLC
Location Address4552 36TH AVE SFargo, ND 58104-5211
Mailing Address4552 36th Ave SFargo, ND 58104-5211 · (701) 478-8655
Phone(701) 478-8655
Organization SubpartNo
Authorized OfficialChad Michael OlsonCfo · (701) 852-7700
Enumeration DateOctober 8, 2020
NPPES CertifiedOctober 8, 2020
✔ NPI 1922605310 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAlzheimer Center (Dementia Center)Nursing & Custodial Care Facilities
Taxonomy Code311500000X
Definition
A freestanding facility or special care unit of a long term care facility focusing on patient care of individuals diagnosed with dementia or Alzheimer's Disease or their related diseases. Six elements of the facility/unit set it apart from other (the rest of the) facilities(y): Admission of residents with dementia (including those with Alzheimer's disease); Staff who are specially selected, trained, and supervised; Activities that are specifically designed for the cognitively impaired; A marketing of a special care unit in brochures; A high level of family involvement; and A physical environment designed to keep residents safe and segregated from other populations.
4552 36TH AVE S, Fargo, ND 58104
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Other Names 1

Doing Business AsMaple View Fargo

Other Identifiers 1

Medicaid1461620ND

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 35D2079940

Fargo Maple View, LLC Dba Maple View Memory Care Fargo · Fargo, ND
Active · expires Jun 25, 2028
CLIA Number35D2079940
Laboratory TypeBasic Care
Certificate Effective DateJune 26, 2026
Certificate Expiration DateJune 25, 2028
Laboratory DirectorMandy Hermanson
Laboratory Phone(701) 478-8655
Laboratory LocationFargo Maple View, LLC Dba Maple View Memory Care Fargo4552 36th Ave S, Fargo, ND 58104
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 Fargo Maple View LLC's NPI number?

The NPI number for Fargo Maple View LLC is 1922605310. It was assigned to this organization in the NPPES registry on October 8, 2020. The provider is doing business as Maple View Fargo.

Where is Fargo Maple View LLC located?

Fargo Maple View LLC is located at 4552 36th Ave S, Fargo, ND 58104. The listed phone number is (701) 478-8655.

What is Fargo Maple View LLC's specialty?

The primary specialty registered for this NPI is Alzheimer Center (Dementia Center) with taxonomy code 311500000X.

Does Fargo Maple View LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 35D2079940) is associated with this NPI, valid through June 25, 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 Fargo Maple View LLC was last updated on October 8, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.