Ebenezer Ridges Assisted Living

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

341422 Issued in MN

Legal business name

EBENEZER RIDGES ASSISTED LIVING

Practice address

13810 Community Dr
Burnsville, MN 55337-4593

Phone

(952) 898-4005

Fax

(952) 435-6686

NPI assigned

Feb 22, 2010

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

Stephan Grygar

Title

Cfo

Phone

(612) 874-3477

Specialties & licenses 1

Addresses

Other names 1

• Arbors at Ridges Doing business as

Part of

Ebenezer Society

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

{
    "created_epoch": "1266796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266796800000",
    "number": "1265754980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13810 COMMUNITY DR",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553374593",
            "telephone_number": "952-898-4005",
            "fax_number": "952-435-6686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13810 COMMUNITY DR",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553374593",
            "telephone_number": "952-898-4005",
            "fax_number": "952-435-6686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EBENEZER RIDGES ASSISTED LIVING",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EBENEZER SOCIETY",
        "enumeration_date": "2010-02-22",
        "last_updated": "2010-02-22",
        "status": "A",
        "authorized_official_last_name": "GRYGAR",
        "authorized_official_first_name": "STEPHAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "612-874-3477"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MN",
            "license": "341422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arbors at Ridges",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Vonnie Eaton, DDS
• Dawn Ebeling
• Patrick Brian Ebeling, M.D.
• Ebenezer Ridges
• Ebenezer Ridges Adult Day Center
• Ebenezer Society, LLC
• Michael John Ebertz, M.D.
• Zakiya Ebrahim
• Brooke Michelle Echter
• Dillon Eddy

• Assisted Living Facility in Burnsville, MN
• Providers in Burnsville, 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 Feb 22, 2010; 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.