Keystone Communities of Prior Lake

Primary specialty

Lodging ProviderTaxonomy code 177F00000X

License

333604 Issued in MN

Legal business name

KEYSTONE COMMUNITIES OF PRIOR LAKE

Practice address

4685 Park Nicollet Ave SE
Prior Lake, MN 55372-3926

Phone

(952) 836-2793

NPI assigned

Dec 28, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Donna Teff

Title

Accounts Supervisor

Phone

(952) 836-2793

Specialties & licenses 1

Addresses

Tax ID family

Keystone Communities of Eagan2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Keystone Communities of Eagan

  • Lodging Provider
  • Eagan, MN
  • NPI 1295891042
  NPD tax ID

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245396084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4685 PARK NICOLLET AVE SE",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553723926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4685 PARK NICOLLET AVE SE",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553723926",
            "telephone_number": "952-836-2793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE COMMUNITIES OF PRIOR LAKE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TEFF",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "ACCOUNTS SUPERVISOR",
        "authorized_official_telephone_number": "952-836-2793"
    },
    "taxonomies": [
        {
            "code": "177F00000X",
            "taxonomy_group": "",
            "desc": "Lodging",
            "state": "MN",
            "license": "333604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Keil, LSN, RN
• Wade Keller, MA, LAMFT
• Dana Kelly, RN,C
• Kes Chiropractic, PA
• Sharon K Kettler, RDH
• Kid Talk Inc
• Kindred Supports LLC (Kindred Supports)
• Marcia Kirk, L.AC.
• Muntas Kiyton
• Melissa Kloss, PSY.D.

• Lodging Provider in Prior Lake, MN
• Providers in Prior Lake, MN by specialty
• Lodging Provider in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.