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General NPI Number Information
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NPI Number | 1013860303
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Entity Type | Organization
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Legal Business Name | CHAMPIONS VILLAGE II, LLC
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Dates
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Enumeration Date | 02/17/2026
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Last Update Date | 02/17/2026
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Provider Practice Location Address
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Address Line | 8001 82ND AVE N
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City | BROOKLYN PARK
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State | MN
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Zip | 55445-2434
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Country | US
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Telephone | 612-817-5100
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Fax | 612-500-4677
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Provider Business Mailing Address
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Address Line | 15570 59TH AVE N
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City | PLYMOUTH
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State | MN
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Zip | 55446-3695
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Country | US
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Telephone | 612-817-5100
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Fax | 612-500-4677
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | LALI GALAN
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Credential |
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Telephone | 612-817-5100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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