OrganizationActive
11020 39th St N Opco LLC
NPI 1801776679 · Assisted Living Facility · Lake Elmo, MN
Provider details
- NPI number
- 1801776679
- Entity type
- Organization
- Primary specialty
- Assisted Living FacilityNursing & Custodial Care Facilities
- Parent organization
- Welltower Trs Holdco LLC
- Authorized official
- Kate Ryg, Clinical Reimbursement Manager
Practice location
11020 39th St N
Lake Elmo, MN 55042-9668
Phone: (612) 276-3877
Fax: (612) 360-2331
Mailing address
5900 Clearwater Dr Ste 500
Minnetonka, MN 55343-8961
Registry dates
- Enumerated
- 2025-09-03
- Last updated
- 2025-09-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.