Provider Demographics
NPI:1124494612
Name:CHERRYWOOD POINTE OF SAVAGE LLC
Entity type:Organization
Organization Name:CHERRYWOOD POINTE OF SAVAGE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:REGIONAL DIRECTOR - ASSISTED LIVING
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:LASON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-425-8681
Mailing Address - Street 1:5950 WEST 130TH LANE
Mailing Address - Street 2:
Mailing Address - City:SAVAGE
Mailing Address - State:MN
Mailing Address - Zip Code:55378
Mailing Address - Country:US
Mailing Address - Phone:952-808-8725
Mailing Address - Fax:
Practice Address - Street 1:5950 WEST 130TH LANE
Practice Address - Street 2:
Practice Address - City:SAVAGE
Practice Address - State:MN
Practice Address - Zip Code:55378-2681
Practice Address - Country:US
Practice Address - Phone:952-808-8725
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DAKOTA HOLDINGS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-08-19
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN28789251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health