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NPI 1447390570 · Intellectual Disabilities Intermediate Care Facility · Coon Rapids, MN
Provider details
- NPI number
- 1447390570
- Entity type
- Organization
- Primary specialty
- Intellectual Disabilities Intermediate Care FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Connie Winbauer, Controller(763) 862-5436
- License
- 1075259 (MN)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
Detailed profile(90/100 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
1555 118th Ln Nw
Coon Rapids, MN 55448-7579
Phone: (763) 862-5436
Fax: (763) 754-0332
Approximate (ZIP-level) locationGet directions
Mailing address
1555 118th Ln Nw
Coon Rapids, MN 55448-7579
Other names (DBA / former)
- Other name
- Mary T Associates
Registry dates
- Enumerated
- 2007-02-07
- 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.