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NPI Code Detail

MEDICARE: ELIM SHORES, INC.

MEDICARE: ELIM SHORES, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1310400000XAssisted Living Facility335373MN

General Provider Information

NPI Number : 1598882334
Entity Type Code : Organization
Provider Name (Legal Business Name) : ELIM SHORES, INC.
Provider Business Mailing Address
First Line : 7171 OHMS LN
Second Line :
City : EDINA
State : MN
Zip : 55439-2142
Country : US
Telephone Number : 529-855-5041
Fax Number : 952-259-4498
Provider Business Practice Location Address
First Line : 7900 TIMBER LAKE DR
Second Line :
City : EDEN PRAIRIE
State : MN
Zip : 55347-1177
Country : US
Telephone Number : 952-934-3005
Fax Number : 952-934-0730
Authorized Official
Title or Position : ASSOCIATE VP OF REVENUE CYCLE MGMT
Name : SEELOCHANI STADTHERR
Credential :
Telephone Number : 952-855-5041
Provider Enumeration Date : 03/26/2007
Last Update Date : 11/21/2025

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Directions to “ELIM SHORES, INC. ” Practice Location

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