OrganizationActive
Community Living
NPI 1457412090 · Intellectual Disabilities Intermediate Care Facility · Coon Rapids, MN
Provider details
- NPI number
- 1457412090
- Entity type
- Organization
- Primary specialty
- Intellectual Disabilities Intermediate Care FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Monica Schmidt, Administrator(952) 443-2048
- License
- 800534 (MN)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
2483 109th Ave Nw
Coon Rapids, MN 55433-3942
Phone: (952) 443-2048
Approximate (ZIP-level) locationGet directions
Mailing address
1600 Arboretum Blvd.
Victoria, MN 55386
Registry dates
- Enumerated
- 2006-12-13
- 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.