4685 Park Nicollet Avenue Opco LLC
NPI #1093604456 in Prior Lake, Minnesota
Provider Information
- NPI Number
- 1093604456
- Entity Type
- Organization
- Organization Name
- 4685 Park Nicollet Avenue Opco LLC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- WELLTOWER TRS HOLDCO LLC
- Primary Specialty
- Assisted Living Facility
- Enumeration Date
- Jul 1, 2025
- Last Updated
- Sep 22, 2025
Practice Location
- Address
- 4685 PARK NICOLLET AVE SE
- City
- Prior Lake
- State
- Minnesota
- ZIP Code
- 55372-3926
- Phone
- (952) 226-9200
Authorized Official
- Name
- KATE RYG
- Title
- CLINICAL REIMBURSEMENT MANAGER
- Phone
- (763) 486-9187
Specialties & Taxonomy Codes
| Specialty |
|---|
| Assisted Living Facility |
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