NPI 1093604456
4685 Park Nicollet Avenue Opco LLC
Practice location
- Address
- 4685 Park Nicollet Ave SE, Prior Lake, MN 55372-3926
- Phone
- (952) 226-9200
- Fax
- (612) 360-2331
- Mailing address
- 5900 Clearwater Dr STE 500, Minnetonka, MN 55343-8961
Authorised official
- Name
- Kate Ryg
- Title
- Clinical Reimbursement Manager
- Phone
- (763) 486-9187
Registered specialties
Assisted Living Facility
Primary
Registry record
- NPI
- 1093604456
- Entity type
- Organization
- NPI issued
- 1 Jul 2025
- Record last updated
- 22 Sep 2025
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.