Provider Demographics
NPI:1487748380
Name:RIVER OAKS COLUMBIA HEIGHTS, LLC
Entity type:Organization
Organization Name:RIVER OAKS COLUMBIA HEIGHTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-258-6284
Mailing Address - Street 1:7437 NARCISSUS LN N
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55311-1726
Mailing Address - Country:US
Mailing Address - Phone:763-782-1601
Mailing Address - Fax:
Practice Address - Street 1:900 42ND AVE NE
Practice Address - Street 2:
Practice Address - City:COLUMBIA HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55421-5601
Practice Address - Country:US
Practice Address - Phone:763-782-1612
Practice Address - Fax:763-781-5874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN332680310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNAL0058OtherU CARE
MN970516300Medicaid
MN4980507OtherMEDICA