FOUNTAIN GATE HEALTH LLC (NPI# 1407491475) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407491475 |
| Entity Type | Organization |
| Organization Name | FOUNTAIN GATE HEALTH LLC |
| Practice Address |
10714 Ilex St Nw Coon Rapids MN 55448-4941 |
| Practice Telephone | 7635168304 |
| Mailing Telephone | 7635168304 |
| Enumeration Date | 2019-11-13 |
| Last Update Date | 2019-11-13 |
| Authorized Official Name | MS. EVELYN MCCARTHY (CEO) |
| Authorized Official Telephone | 7635168304 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251E00000X | Home Health | Agencies | ||
| N | 253Z00000X | In Home Supportive Care | Agencies | ||
| N | 3104A0625X |
Assisted Living Facility Specialization: Assisted Living, Mental Illness |
Nursing & Custodial Care Facilities | ||
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Street Address |
10714 ILEX ST NW |
| City | COON RAPIDS |
| State | MN |
| Zip Code | 55448-4941 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447741152 | Modern Sisters Home Healthcare | Home Health | 1852 131st Ln Nw, Coon Rapids, MN 55448 | 2018-05-29 |
| 1003345463 | Sarah Benepe | Occupational Therapy Assistant | 764 107th Ln Nw, Coon Rapids, MN 55448 | 2017-06-08 |
| 1700310299 | Orthodontics Specialist of Minnesota P.l.l.c. | Dentist | 3360 Northdale Blvd Nw, Coon Rapids, MN 55448 | 2017-04-12 |
| 1528459906 | Shane R Fisher | Registered Nurse | 10077 Dogwood St. Nw, Suite 110, Minneapolis, MN 55448 | 2015-02-06 |
| 1912395419 | Mn Dentistry, PC | Dentist | 3570 River Rapids Drive Nw, Ste 110, Coor Rapids, MN 55448 | 2015-01-06 |
| 1215297536 | Daniel Beau Ryan Ellis | Chiropractor | 9 125 Lane Nw, Coon Rapids, MN 55448 | 2012-05-21 |
| 1306142344 | At Home Health Care Inc. | Home Health | 1601 128th Lane Nw, Coon Rapids, MN 55448 | 2011-02-09 |
| 1245428317 | Cassandra Joice Carney | Massage Therapist | 8770 Springbrook Dr Nw, Coon Rapids, MN 55448 | 2007-10-14 |
| 1982826434 | Merry Heart Home Care Inc | Home Health | 3248 131st Avenue Nw, Coon Rapids, MN 55448 | 2007-05-03 |
| 1659416196 | James T Sturm | Emergency Medicine | 10160 Foley Blvd Nw Ste 120, Coon Rapids, MN 55448 | 2007-02-21 |
| Find all providers in zip 55448 | ||||
| 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 |
|---|---|---|---|---|
| 1508221136 | Autumn Glen Senior Living LLC | Assisted Living Facility | 3715 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-2777 | 2015-12-26 |
| 1063797215 | Margaret Place Limited Partnership | Assisted Living Facility | 1190 117th Ave Nw, Coon Rapids, MN 55448-2383 | 2011-10-19 |
| 1235414483 | Margaret Place Limited Partnership | Assisted Living Facility | 12009 Eagle St Nw, Coon Rapids, MN 55448-1909 | 2011-10-19 |
| 1902189350 | Margaret Place Limited Partnership | Assisted Living Facility | 11777 Xeon Blvd Nw, Coon Rapids, MN 55448-2060 | 2011-09-22 |
| 1578878773 | Voa Care Centers, Minnesota | Assisted Living Facility | 1770 113th Ln Nw, Coon Rapids, MN 55433-3019 | 2010-08-11 |
| 1720252836 | Select Senior Living of Coon Rapids, LLC | Assisted Living Facility | 11350 Martin St Nw, Coon Rapids, MN 55433-3988 | 2008-04-18 |
| 1558483081 | Voa Care Centers, Minnesota | Assisted Living Facility | 11372 Robinson Dr Nw, Coon Rapids, MN 55433-3776 | 2007-04-04 |
| 1578028585 | The Homestead At Coon Rapids, Inc. | Assisted Living Facility | 11372 Robinson Dr Nw, Coon Rapids, MN 55433-4071 | 2019-02-04 |
| 1104323773 | New Western Manor Company Limited Partnership | Assisted Living Facility | 3715 Coon Rapids Blvd Nw, Coon Rapids, MN 55433 | 2018-04-10 |
| 1710262399 | Margaret Place Limited Partnership | Assisted Living Facility | 1555 118th Ln Nw, Coon Rapids, MN 55448-7579 | 2011-10-14 |
| Find all providers in COON RAPIDS | ||||
| City | COON RAPIDS |
| Zip Code | 55448 |
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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.