FOND DU LAC RESERVATION BUSINESS COMMITTEE (NPI# 1134426778) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134426778 |
| Entity Type | Organization |
| Organization Name | FOND DU LAC RESERVATION BUSINESS COMMITTEE |
| Other Organization Name | FOND DU LAC ASSISTED LIVING |
| Practice Address |
1571 Airport Road Fond Du Lac Assisted Living Cloquet MN 55720 |
| Mailing Address |
927 Trettel Lane Fond Du Lac Human Services Division Cloquet MN 55720 |
| Practice Telephone | 2188791227 |
| Practice Fax Number | 2188783755 |
| Mailing Telephone | 2188791227 |
| Mailing Fax Number | 2188783755 |
| Enumeration Date | 2011-02-17 |
| Last Update Date | 2016-03-22 |
| Authorized Official Name | MRS. MARILYN GROVER (ASSOCIATE DIRECTOR) |
| Authorized Official Telephone | 2188791227 |
| Is Organization Subpart | Y |
| Parent Organization Name | FOND DU LAC HUMAN SERVICES DIVISION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 310400000X | Assisted Living Facility | 25541M | MN | Nursing & Custodial Care Facilities |
| N | 310400000X | Assisted Living Facility | 348710 | MN | Nursing & Custodial Care Facilities |
| Y | 310400000X | Assisted Living Facility | 349645 | MN | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Fond du Lac Assisted Living | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629256763 | Fond Du Lac Reservation Business Committee | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 221 W 4th St, Duluth, MN 55806-2719 | 2008-01-31 |
| 1326053166 | Fond Du Lac Reservation Business Committee | Durable Medical Equipment & Medical Supplies | 927 Trettle Lane, Fond Du Lac Human Services Division, Cloquet, MN 55720 | 2006-07-30 |
| 1053772087 | Fond Du Lac Reservation Business Committee | Clinic/Center | 927 Trettel Ln, Cloquet, MN 55720-1345 | 2016-03-18 |
| 1346501392 | Fond Du Lac Reservation Business Committee | Pharmacy | 927 Trettel Ln, Cloquet, MN 55720-1345 | 2012-06-06 |
| 1225335862 | Fond Du Lac Reservation Business Committee | Clinic/Center | 927 Trettel Lane, Fond Du Lac Human Services Division, Cloquet, MN 55720 | 2011-02-17 |
| 1700064714 | Fond Du Lac Reservation Business Committee | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 2020 Bloomington Ave, Minneapolis, MN 55404-3073 | 2008-02-01 |
| Street Address |
1571 AIRPORT ROAD FOND DU LAC ASSISTED LIVING |
| City | CLOQUET |
| State | MN |
| Zip Code | 55720 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447786652 | Awakening Growth, LLC | Social Worker | 116 Ave C, Cloquet, MN 55720 | 2017-05-08 |
| 1396129706 | Kara Danielle Ebert | Marriage & Family Therapist | 913 Stanley Ave, Cloquet, MN 55720 | 2015-07-15 |
| 1639577729 | Fcsl Cloquet, LLC | Assisted Living Facility | 130 W North Road, Cloquet, MN 55720 | 2014-12-05 |
| 1699173765 | Fcsl Cloquet, LLC | Assisted Living Facility | 132 W North Road, Cloquet, MN 55720 | 2014-12-05 |
| 1417124553 | Kara Lynn Fausch | Family Medicine | 512 Skyline Boulevard, Cloquet, MN 55720 | 2008-05-08 |
| 1013199769 | Carlton Co Public Health & Human Services | Public Health or Welfare | 30 N 10th Street, Cloquet, MN 55720 | 2007-12-04 |
| 1881808616 | Stephen David Parkhurst | Chiropractor | 903 Cloquet Avenue, Cloquet, MN 55720 | 2007-05-10 |
| 1093929861 | Northland Afc,inc | Day Training, Developmentally Disabled Services | 1576 White Pine Trail, Cloquet, MN 55720 | 2007-05-10 |
| 1235341231 | Northland Afc,inc | Day Training, Developmentally Disabled Services | 6580 W Arrowhead Rd., Cloquet, MN 55720 | 2007-05-04 |
| 1225251556 | Five Star Living of Cloquet, LLC | Assisted Living Facility | 130 West North Rd, Cloquet, MN 55720 | 2007-04-11 |
| Find all providers in zip 55720 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639577729 | Fcsl Cloquet, LLC | Assisted Living Facility | 130 W North Road, Cloquet, MN 55720 | 2014-12-05 |
| 1699173765 | Fcsl Cloquet, LLC | Assisted Living Facility | 132 W North Road, Cloquet, MN 55720 | 2014-12-05 |
| 1639347354 | Five Star Living of Cloquet LLC | Assisted Living Facility | 130 North Rd, Cloquet, MN 55720-1171 | 2008-02-15 |
| 1346436565 | Split Rock Operations | Assisted Living Facility | 1909 Tall Pine Ln, Cloquet, MN 55720-2826 | 2007-09-20 |
| 1225251556 | Five Star Living of Cloquet, LLC | Assisted Living Facility | 130 West North Rd, Cloquet, MN 55720 | 2007-04-11 |
| 1689752800 | Duluth Health Services | Assisted Living Facility | 2400 Washington Ave, Cloquet, MN 55720 | 2006-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871193417 | Midwest Group Home | Assisted Living Facility | 4232 5th St Ne, Columbia Heights, MN 55421-2860 | 2020-10-30 |
| 1710587696 | Friesen & Friesen, Inc | Assisted Living Facility | 1971 Ne 1st Avenue, Grand Rapids, MN 55744 | 2020-10-29 |
| 1750980603 | Estherra Care LLC | Assisted Living Facility | 1120 Morgan Ave N, Minneapolis, MN 55411-3805 | 2020-10-21 |
| 1679189682 | Daniel Care Homes LLC | Assisted Living Facility | 6809 Perry Ave N, Brooklyn Center, MN 55429-1611 | 2020-09-16 |
| 1326651779 | Secured Health and Homecare Inc | Assisted Living Facility | 4519 104th Ave N, Brooklyn Park, MN 55443-1030 | 2020-08-26 |
| 1811509870 | Aurora Assisted Living LLC | Assisted Living Facility | 115 Magnolia Ave W, Saint Paul, MN 55117-4916 | 2020-08-20 |
| 1003427477 | In My Father's House | Assisted Living Facility | 3096 Snelling Ave N, Roseville, MN 55113-1659 | 2020-08-11 |
| 1710595863 | Eden Prairie Senior Living | Assisted Living Facility | 8480 Franlo Rd, Eden Prairie, MN 55344-2938 | 2020-07-15 |
| 1447868468 | Brightstar Services LLC | Assisted Living Facility | 1821 University Ave W Ste 120, Saint Paul, MN 55104-2811 | 2020-07-15 |
| 1235757667 | Roers Senior Living Buffalo LLC | Assisted Living Facility | 150 Division Street East, Buffalo, MN 55313 | 2020-07-13 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.