Organization · Type 2 NPI

4685 Park Nicollet Avenue Opco LLC

Assisted Living Facility · Prior Lake, MN

NPI number 1093604456 Active

Practice location

4685 Park Nicollet Ave SE
Prior Lake, MN 55372-3926

Call (952) 226-9200 Map

Fax (612) 360-2331

Mailing address

5900 Clearwater Dr Ste 500
Minnetonka, MN 55343-8961

Specialties and licenses

TaxonomyCodeLicense
Assisted Living Facility Primary 310400000XNone listed

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.

4 other providers at this address

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About NPI 1093604456

4685 Park Nicollet Avenue Opco LLC's National Provider Identifier is 1093604456, issued on Jul 1, 2025. The primary taxonomy on file is Assisted Living Facility (310400000X), and the practice location is in Prior Lake, MN. The record was last updated on Sep 22, 2025.