Fairview Woods

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

335981 Issued in MN

Legal business name

FAIRVIEW WOODS

Practice address

470 Fairview Blvd
Red Wing, MN 55066-2862

Phone

(651) 267-5444

NPI assigned

Feb 20, 2008

Organization subpart

Yes

Parent organization

EBENEZER SOCIETYAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lucy Boxrud

Title

Housing Manager

Phone

(651) 267-5441

Specialties & licenses 2

Addresses

Other names 1

• Ebenezer at Fairview Doing business as

Part of

Ebenezer Society

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1203465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203465600000",
    "number": "1053589358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "470 FAIRVIEW BLVD",
            "city": "RED WING",
            "state": "MN",
            "postal_code": "550662862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 FAIRVIEW BLVD",
            "city": "RED WING",
            "state": "MN",
            "postal_code": "550662862",
            "telephone_number": "651-267-5444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRVIEW WOODS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EBENEZER SOCIETY",
        "enumeration_date": "2008-02-20",
        "last_updated": "2008-02-20",
        "status": "A",
        "authorized_official_last_name": "BOXRUD",
        "authorized_official_first_name": "LUCY",
        "authorized_official_title_or_position": "HOUSING MANAGER",
        "authorized_official_telephone_number": "651-267-5441"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MN",
            "license": "335979",
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MN",
            "license": "335981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ebenezer at Fairview",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Lillian Eustis
• Madison Marian Exe
• Fairview Seminary Home
• William David Farrar, M.D.
• Patricia Ann Fenstermacher, ARNP
• Fernbrook Family Center
• Bernie Orders Finch, DC
• Kerry A Finne

• All providers in Red Wing, MN
• Assisted Living Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.