OrganizationActive
Phs Interlude Fridley LLC
NPI 1740697291 · Skilled Nursing Facility · Fridley, MN
Provider details
- NPI number
- 1740697291
- Entity type
- Organization
- Primary specialty
- Skilled Nursing FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Nicole Donahue, Ceo/Administrator(763) 230-3141
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
Detailed profile(75/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
11 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
520 Osborne Rd Ne
Fridley, MN 55432-2718
Phone: (763) 230-3131
Street-level locationGet directions
Mailing address
520 Osborne Rd Ne
Fridley, MN 55432-2718
Registry dates
- Enumerated
- 2014-07-16
- Last updated
- 2017-12-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.