National Provider Identifier Database

COMMUNITY LIVING
Intermediate Care Facility, Mentally Retarded

(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals.


Contact Information

COMMUNITY LIVING
2483 109TH AVE NW
COON RAPIDS, MN55433-3942
Phone: 952-443-2048
Fax:
Website:
Specialty Taxonomy Code
* Intermediate Care Facility, Mentally Retarded 315P00000X

* Indicates primary specialty

NPI Profile & details for COMMUNITY LIVING

NPI Number 1457412090
Legal business name
LBN
COMMUNITY LIVING
Authorized official MONICA SCHMIDT - (ADMINISTRATOR)
Entity Organization
Organization subpart No
Enumeration date 12/13/2006
Last updated 08/22/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • MN License #: 800534

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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