Provider Demographics
NPI:1154893907
Name:MINNETONKA OPS LLC
Entity type:Organization
Organization Name:MINNETONKA OPS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF FINANCE & ACCOUNTING
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:MASSOPUST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-241-8211
Mailing Address - Street 1:7625 GOLDEN TRIANGLE DR STE T
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-3700
Mailing Address - Country:US
Mailing Address - Phone:952-241-8211
Mailing Address - Fax:
Practice Address - Street 1:500 CARLSON PKWY
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-5304
Practice Address - Country:US
Practice Address - Phone:952-746-3630
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-18
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility