CAMILIA ROSE CARE CENTER LLC
NPI 1962499566
Skilled Nursing Facility in Coon Rapids, MN

Active since September 29, 2005CLIA Certified · 2 labs
11800 XEON BLVD NW, COON RAPIDS, MN 55448(763) 755-8400(783) 755-8578 Get Directions Write a Review

NPPES record last updated: February 10, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Camilia Rose Care Center Llc NPPES

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

CAMILIA ROSE CARE CENTER LLC (NPI 1962499566) is a healthcare organization registered as a skilled nursing facility in Coon Rapids, Minnesota and active in the NPI registry since September 2005. The organization holds 2 active CLIA laboratory certificates and lists Jason Tjosvold, Secretary & Treasurer, as its authorized official.

NPPES Registry Identity

NPI1962499566
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameCAMILIA ROSE COMPANY INC
Location Address11800 XEON BLVD NWCoon Rapids, MN 55448-2061
Mailing Address11800 Xeon Blvd NwCoon Rapids, MN 55448-2061 · (763) 755-8400 · Fax (783) 755-8578
Fax(783) 755-8578
Organization SubpartYes
Authorized OfficialJason TjosvoldSecretary & Treasurer · (763) 567-8951
Enumeration DateSeptember 29, 2005
Last NPPES UpdateFebruary 10, 2020
NPI 1962499566 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in MN · 326976
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
11800 XEON BLVD NW, Coon Rapids, MN 55448

Other Names 1

Doing Business AsCamilia Rose Care Center Llc

Other Identifiers 1

Medicaid231243300MN

CLIA Laboratory Certificates CMS CLIA 2

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 24D2268643

Camilia Rose Assisted Living, Mary T Associates Inc · Coon Rapids, MN
Active · expires Sep 14, 2026
CLIA Number24D2268643
Laboratory TypeAssisted Living Facility
Certificate Effective DateSeptember 15, 2024
Certificate Expiration DateSeptember 14, 2026
Laboratory DirectorWendy Rischmiller
Laboratory Phone(763) 746-3717
Laboratory LocationCamilia Rose Assisted Living, Mary T Associates Inc11800 Xeon Blvd NW, Coon Rapids, MN 55448
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 24D2293633

Camilia Rose Cottage, Mary T · Coon Rapids, MN
Active · expires Nov 12, 2027
CLIA Number24D2293633
Laboratory TypeSupervised Living Fac
Certificate Effective DateNovember 13, 2025
Certificate Expiration DateNovember 12, 2027
Laboratory DirectorLisa Baum
Laboratory Phone(763) 754-2505
Laboratory LocationCamilia Rose Cottage, Mary T1154 117th Ave NW, Coon Rapids, MN 55448
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 19

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Occupational Therapist
11800 XEON BLVD NW
COON RAPIDS, MN 55448
Speech-Language Pathologist
11800 XEON BLVD NW
COON RAPIDS, MN 55448
Physical Therapist
11800 XEON BLVD NW
COON RAPIDS, MN 55448
Physical Therapist
11800 XEON BLVD NW
COON RAPIDS, MN 55448
Occupational Therapist
11800 XEON BLVD NW
COON RAPIDS, MN 55448
Physical Therapy Assistant
11800 XEON BLVD NW
COON RAPIDS, MN 55448
Occupational Therapist
11800 XEON BLVD NW
COON RAPIDS, MN 55448
Physical Therapist
11800 XEON BLVD NW
COON RAPIDS, MN 55448

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 Camilia Rose Company Inc's NPI number?

The NPI number for Camilia Rose Company Inc is 1962499566. It was assigned to this organization in the NPPES registry on September 29, 2005. The provider is doing business as Camilia Rose Care Center LLC.

Where is Camilia Rose Company Inc located?

Camilia Rose Company Inc is located at 11800 Xeon Blvd NW, Coon Rapids, MN 55448. The listed phone number is (763) 755-8400.

What is Camilia Rose Company Inc's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Camilia Rose Company Inc hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Camilia Rose Company Inc was last updated on February 10, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.