Provider Demographics
NPI:1760861975
Name:COMMUNITY ASSET FOUNDATION, LLC
Entity Type:Organization
Organization Name:COMMUNITY ASSET FOUNDATION, LLC
Other - Org Name:THE LODGE OF TAYLORS FALLS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:C
Authorized Official - Last Name:POKORNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-703-5709
Mailing Address - Street 1:4800 W 57TH ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-2239
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1051 MULBERRY STREET
Practice Address - Street 2:
Practice Address - City:TAYLORS FALLS
Practice Address - State:MN
Practice Address - Zip Code:55084
Practice Address - Country:US
Practice Address - Phone:651-240-0140
Practice Address - Fax:651-240-0141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-20
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility