Provider Demographics
NPI:1154893907
Name:500 CARLSON PARKWAY OPCO LLC
Entity type:Organization
Organization Name:500 CARLSON PARKWAY OPCO LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL REIMBURSEMENT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATE
Authorized Official - Middle Name:
Authorized Official - Last Name:RYG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-486-9187
Mailing Address - Street 1:5900 CLEARWATER DR STE 500
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55343-8961
Mailing Address - Country:US
Mailing Address - Phone:952-241-8211
Mailing Address - Fax:612-360-2331
Practice Address - Street 1:500 CARLSON PKWY
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-5304
Practice Address - Country:US
Practice Address - Phone:952-746-3630
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WELLTOWER TRS HOLDCO LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-12-18
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility