The Emeralds at Faribault Assisted Living LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

THE EMERALDS AT FARIBAULT ASSISTED LIVING LLC

Practice address

503 Division St E
Faribault, MN 55021-6353

Phone

(507) 332-5158

NPI assigned

Mar 20, 2019

Organization subpart

No

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

Authorized official

Name

Josh Legum

Title

Ceo

Phone

(507) 203-1001

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553040000000",
    "number": "1295295954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "638 SOUTHBEND AVE",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560012168",
            "telephone_number": "507-203-1001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 DIVISION ST E",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550216353",
            "telephone_number": "507-332-5158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE EMERALDS AT FARIBAULT ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-20",
        "last_updated": "2019-03-20",
        "status": "A",
        "authorized_official_last_name": "LEGUM",
        "authorized_official_first_name": "JOSH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "507-203-1001"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann Margaret Taylor Sundstrom, LICENSED PSYCHOLOGIS
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• Mary Jane Tetzloff, MD
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• Deborah Ann Thibodeau, RPH
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• Assisted Living Facility in Faribault, MN
• Providers in Faribault, 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 Mar 20, 2019; 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.