OrganizationActive
Champlin Shores LLC
NPI 1194845107 · Assisted Living Facility · Champlin, MN
Provider details
- NPI number
- 1194845107
- Entity type
- Organization
- Primary specialty
- Assisted Living FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Jon Harder, Manager(503) 485-4600
- License
- 333870 (MN)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
119 Hayden Lake Rd E
Champlin, MN 55316-1547
Phone: (763) 712-0118
Street-level locationGet directions
Mailing address
3723 Fairview Industrial Dr Se Ste 270
Salem, OR 97302-4975
Other names (DBA / former)
- Doing business as
- Champlin Shores
Registry dates
- Enumerated
- 2007-03-31
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.