Split Rock Operations

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

PENDING Issued in MN

Legal business name

SPLIT ROCK OPERATIONS

Doing business as

Horizons Assisted Living

Practice address

1909 Tall Pine LN
Cloquet, MN 55720-2826

Phone

(218) 391-9199

Fax

(218) 345-8880

NPI assigned

Sep 20, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Ryan Novaczyk

Title

Cfo

Phone

(612) 840-3924

Specialties & licenses 1

Addresses

Other names 1

• Horizons Assisted Living Doing business as

Locations

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

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190246400000",
    "number": "1346436565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 224",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557200224",
            "telephone_number": "612-840-3924",
            "fax_number": "866-316-6640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 TALL PINE LN",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557202826",
            "telephone_number": "218-391-9199",
            "fax_number": "218-345-8880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPLIT ROCK OPERATIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-20",
        "last_updated": "2007-09-20",
        "status": "A",
        "authorized_official_last_name": "NOVACZYK",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "612-840-3924",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MN",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Horizons Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tawny Lee Smith-Savage, LCSW LADC
• Jeremy Clinton Smith, RD
• Katrina Reanne Smith
• Sound Mind Behavioral Health, PLLC
• Chad Michael Spillers, D.C.
• Nicholas Allen Spolarich
• Katherine Dunstan St. Cyr, PHARMD
• St. Luke'S Hospital of Duluth
• Carmen Stanfield
• Sophia Stangl, DDS

• Assisted Living Facility in Cloquet, MN
• Providers in Cloquet, 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 Sep 20, 2007; 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.