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Phs-White Bear Lake LLC

NPI 1003563545ActiveOrganization· Assisted Living Facility· White Bear Lake, MN

Assisted Living Facility in White Bear Lake, Minnesota, registered in NPPES in March 2022. The authorized official on file is Jon Tranby, Payer Relations Director.

Overview

NPI1003563545
StatusActive
Entity typeOrganization
NPI issuedMar 4, 2022
Last updated in NPPESAug 18, 2026
Certified by providerAug 18, 2026

Specialties and licenses

TaxonomyCodeLicenseState
Assisted Living Facility Primary310400000X——

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Nov 10, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 11, 2026No match—
New York OMIG · Nov 11, 2026No match—
Ohio Medicaid · Nov 11, 2026No match—
Pennsylvania Medicheck · Nov 11, 2026No match—
Washington HCA · Nov 11, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Not in the public enrollment file of Oct 1, 2026

Medicare sources and data years

Other Assisted Living Facility providers in White Bear Lake

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