NPI 1003683913

Chimney Pines LLC

Organisation Assisted Living Facility Eden Prairie, MN

Practice location

Address: 10452 Spyglass Dr, Eden Prairie, MN 55347-4656
Phone: (612) 508-8743
Mailing address: 10428 Shelter Grv, Eden Prairie, MN 55347-4855

Authorised official

Name: Phouvieng Sivilay
Title: Director/Manager
Phone: (612) 508-8743

Registered specialties

Assisted Living Facility Primary

Nursing & Custodial Care Facilities Taxonomy 310400000X

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Registry record

NPI: 1003683913
Entity type: Organization
NPI issued: 11 Dec 2023
Record last updated: 11 Dec 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.