NPIMap

Organization Active NPI

MSL-Ebt LLC

  • Assisted Living Facility
  • Brooklyn Center, MN
National Provider Identifier
1366817819
Registry record updated Dec 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
375200 Issued in MN
Legal business name
MSL-EBT LLC
Practice address
6100 Summit Dr N
Brooklyn Center, MN 55430-2151
Phone
(763) 560-6829
NPI assigned
Dec 9, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2015

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

Authorized official

Name
Charles E Trefzger
Title
Manager
Phone
(828) 322-5535

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 375200 MN Primary

Addresses

Primary practice location

6100 Summit Dr N
Brooklyn Center, MN 55430-2151

Mailing address

PO Box 2568
Hickory, NC 28603-2568
Phone (828) 322-5535

Other names 1

  • Earle Brown Terrace Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1449619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449619200000",
    "number": "1366817819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2568",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286032568",
            "telephone_number": "828-322-5535",
            "fax_number": "828-326-8115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 SUMMIT DR N",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554302151",
            "telephone_number": "763-560-6829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MSL-EBT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-09",
        "last_updated": "2015-12-09",
        "status": "A",
        "authorized_official_last_name": "TREFZGER",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "828-322-5535"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MN",
            "license": "375200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Earle Brown Terrace",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brooklyn Center, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2015; 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.