NPI 1679916571 · live from the CMS NPI Registry
Ebenezer Lakes Assisted Living
Skilled Nursing Facility in Wyoming, MN. National Provider Identifier 1679916571, active.
NPI record
| NPI | 1679916571 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Skilled Nursing Facility 314000000X |
| Practice location | 25565 Fairview Ave, Wyoming, MN 55092 |
| Practice phone | 651-982-6228 |
| Enumerated | April 10, 2013 |
| Last updated | December 30, 2016 |
| Authorized official | Kari Wilson, Campus Director |
| Other names | Meadows On Fairview |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Skilled Nursing Facility primary | 314000000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.