Provider Demographics
NPI:1215510037
Name:CARDIGAN RIDGE SENIOR LIVING
Entity type:Organization
Organization Name:CARDIGAN RIDGE SENIOR LIVING
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:SHOSHANA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIEDLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-578-2432
Mailing Address - Street 1:820 LILAC DR N
Mailing Address - Street 2:
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55422-4700
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3300 RICE ST
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55126-4614
Practice Address - Country:US
Practice Address - Phone:651-484-8484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ELK RIVER SENIOR CARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-04-29
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility