NPI 1477423556 · live from the CMS NPI Registry
Crestview Residences LLC
Skilled Nursing Facility in Minneapolis, MN. National Provider Identifier 1477423556, active.
NPI record
| NPI | 1477423556 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Skilled Nursing Facility 314000000X |
| Practice location | 4444 Reservoir Blvd, Minneapolis, MN 55421 |
| Practice phone | 763-782-1611 |
| Mailing address | 1345 Corporate Center Curv, Eagan, MN 55121 |
| Enumerated | November 5, 2025 |
| Last updated | November 5, 2025 |
| Authorized official | Josh Legum, President |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Skilled Nursing Facility primary | 314000000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.