Pillars of Hermantown LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

PILLARS OF HERMANTOWN LLC

Practice address

4110 Lavaque Rd.
Hermantown, MN 55811

Phone

(218) 600-5755

NPI assigned

Jan 31, 2024

Organization subpart

No

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

Authorized official

Name

Nikoletta Bystrzycka

Title

Ed

Phone

(218) 600-5755

Specialties & licenses 1

Addresses

Other names 1

• The Pillars of Hermantown Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1706659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706659200000",
    "number": "1205699592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 LAVAQUE RD.",
            "city": "HERMANTOWN",
            "state": "MN",
            "postal_code": "55811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 LAVAQUE RD.",
            "city": "HERMANTOWN",
            "state": "MN",
            "postal_code": "55811",
            "telephone_number": "218-600-5755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PILLARS OF HERMANTOWN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-31",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-29",
        "status": "A",
        "authorized_official_last_name": "BYSTRZYCKA",
        "authorized_official_first_name": "NIKOLETTA",
        "authorized_official_title_or_position": "ED",
        "authorized_official_telephone_number": "218-600-5755"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Pillars of Hermantown",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael Perell, PHARMD
• Rachael Perkins
• Joslyn P Peterson
• Tommi Marie Peterson
• Jennifer Piasecki
• Kelly A Plote, DDS
• Heather Lynn Prekop
• Psych Solutions LLC
• Malia Elizabeth Putzel
• Audrey Robin Quach

• Assisted Living Facility in Hermantown, MN
• Providers in Hermantown, MN by specialty
• Assisted Living Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.