Healthcare Provider Details
I. General information
NPI: 1801704887
Provider Name (Legal Business Name): PLACE OF JOY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11600 NORWAY ST NW
COON RAPIDS MN
55448-2359
US
IV. Provider business mailing address
10542 WESTON WAY N
MAPLE GROVE MN
55369-4162
US
V. Phone/Fax
- Phone: 612-860-2906
- Fax:
- Phone: 612-860-2906
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 310400000X |
| Taxonomy | Assisted Living Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LUCY
M
CHARI
Title or Position: AUTHORIZED AGENT
Credential:
Phone: 612-860-2906