Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

4685 Park Nicollet Avenue Opco LLC

Organization Assisted Living Facility · NPI 1093604456

4685 Park Nicollet Avenue Opco LLC is an Assisted Living Facility in Prior Lake, Minnesota. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

4685 Park Nicollet Ave SE
Prior Lake, MN 55372-3926
Phone: (952) 226-9200
Fax: (612) 360-2331
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Assisted Living Facility (primary) Taxonomy 310400000X

Record details

NPI number1093604456
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationWelltower Trs Holdco LLC
Authorized official Kate Ryg — Clinical Reimbursement Manager · (763) 486-9187
NPI enumeratedJuly 1, 2025
Last updated in NPPESSeptember 22, 2025
Certification dateSeptember 22, 2025
Mailing address5900 Clearwater Dr Ste 500, Minnetonka, MN 55343-8961

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