Provider Demographics
NPI:1164382412
Name:ZEN LIVING ON LLC
Entity type:Organization
Organization Name:ZEN LIVING ON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CASE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KARI
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BERGERON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-691-3578
Mailing Address - Street 1:13721 TEAKWOOD LN N
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:MN
Mailing Address - Zip Code:55327-7507
Mailing Address - Country:US
Mailing Address - Phone:763-691-3578
Mailing Address - Fax:
Practice Address - Street 1:260 5TH AVE SE
Practice Address - Street 2:
Practice Address - City:MILACA
Practice Address - State:MN
Practice Address - Zip Code:56353-1347
Practice Address - Country:US
Practice Address - Phone:763-691-3578
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-17
Last Update Date:2025-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management