KEYSTONE COMMUNITIES OF PRIOR LAKE (NPI# 1245396084) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245396084 |
| Entity Type | Organization |
| Organization Name | KEYSTONE COMMUNITIES OF PRIOR LAKE |
| Practice Address |
4685 Park Nicollet Ave Se Prior Lake MN 55372-3926 |
| Practice Telephone | 9528362793 |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DONNA TEFF (ACCOUNTS SUPERVISOR) |
| Authorized Official Telephone | 9528362793 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 177F00000X | Lodging | 333604 | MN | Other Service Providers |
| Street Address |
4685 PARK NICOLLET AVE SE |
| City | PRIOR LAKE |
| State | MN |
| Zip Code | 55372-3926 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972008522 | Katherine Price | Occupational Therapist | 4685 Park Nicollet Ave Se, Prior Lake, MN 55372-3926 | 2018-03-27 |
| 1003292962 | Prior Lake Ops LLC | Assisted Living Facility | 4685 Park Nicollet Ave Se, Prior Lake, MN 55372-3926 | 2015-08-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043830995 | Abby Lynn Quinnell | Physician Assistant | 19455 Towering Oaks Trl, Prior Lake, MN 55372 | 2020-04-21 |
| 1659914547 | Touching Lives Community, Inc. | Assisted Living Facility | 5554 Woodside Road, Se, Prior Lake, MN 55372 | 2019-10-23 |
| 1366961542 | Doreen Lubi Isubikalu | Family Medicine | 2330 Sioux Trail Nw, Prior Lake, MN 55372 | 2017-09-19 |
| 1760909519 | Terese Marie Sovis | Massage Therapist | 15140 Green Oaks Trail, Prior Lake, MN 55372 | 2017-08-23 |
| 1689805301 | Laura Grace Patton | Physician Assistant | 4151 Willowwood Street Se, Prior Lake, MN 55372 | 2009-07-29 |
| 1952582702 | Lilah Suzan Ekim Dds, Ms. Pllc | Dentist | 16190 Erie Ave Se, Prior Lake, MN 55372 | 2007-11-21 |
| 1679618326 | Basile Orthodontics Pa | Dentist | 5116 Gateway Street Se #103, Suite #103, Prior Lake, MN 55372 | 2007-02-20 |
| 1700890134 | Shakopee Mdewakanton Emergency Services | Ambulance | 2525 Flandreau Trail, Prior Lake, MN 55372 | 2006-07-28 |
| 1548299167 | Darlene Merchant | Psychologist | 15815 Franklin Trail S.e., Suite 308 Darlene Merchant, M.a., L.p., Prior Lake, MN 55372 | 2006-07-03 |
| 1508806530 | Kelly Brooks | Nurse Anesthetist, Certified Registered | 3564 Willow Beach St Sw, Prior Lake, MN 55372 | 2006-06-07 |
| Find all providers in zip 55372 | ||||
| Taxonomy Code | 177F00000X |
| Grouping | Other Service Providers |
| Classification | Lodging |
| A public or privately owned facility providing overnight lodging to individuals traveling long distances or receiving prolonged outpatient medical services away from home. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174122758 | Kmjv Operation LLC | Lodging | 19351 Indiana Ave, Lakeville, MN 55044-4849 | 2020-10-23 |
| 1396395349 | Jerald Mitchell | Lodging | 120 3rd Ave N, Biwabik, MN 55708-3032 | 2019-09-11 |
| 1124687322 | Thibodeaux Real Estate Conglomerate | Lodging | 4245 Golden Valley Rd, Golden Valley, MN 55422-4215 | 2019-06-11 |
| 1417416504 | The Chestnut Burrow | Lodging | 423 Chestnut St, Virginia, MN 55792-2525 | 2019-03-18 |
| 1194213280 | Amherst H. Wilder Foundation | Lodging | Lincoln Place, 1997 Gold Trail, Eagan, MN 55122 | 2018-04-25 |
| 1558874743 | Kelly-norton Programs, Inc. | Lodging | 1928 Stevens Ave, Minneapolis, MN 55403-3835 | 2017-11-09 |
| 1114441987 | Darlene Benson | Lodging | 22383 Nebish Rd Ne, Blackduck, MN 56630-5138 | 2017-08-02 |
| 1972816155 | Erie Beehler | Lodging | 12407 Parkwood Ln Nw, Bemidji, MN 56601-6178 | 2010-07-16 |
| 1487966115 | Michele Astrup | Lodging | 21251 Co 35, Underwood, MN 56586 | 2010-07-10 |
| 1336466614 | Kristin Zachman | Lodging | 5080 Naber Ave Ne, Saint Michael, MN 55376-9424 | 2010-04-27 |
| Find all providers with the same taxonomy | ||||
| City | PRIOR LAKE |
| Zip Code | 55372 |
Please comment or provide details below to improve the information on KEYSTONE COMMUNITIES OF PRIOR LAKE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.