East Vernon Residence LLC

Primary specialty

Foster Care AgencyTaxonomy code 253J00000X

Legal business name

EAST VERNON RESIDENCE LLC

Practice address

218 E Vernon Ave
Fergus Falls, MN 56537-2924

Phone

(815) 257-0020

NPI assigned

Sep 21, 2018

Last updated

Sep 21, 2018By 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

Mrs. Beth Alison Clarkson

Title

President

Phone

(815) 257-0020

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1537488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537488000000",
    "number": "1376027672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 E VERNON AVE",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565372924",
            "telephone_number": "815-257-0020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 E VERNON AVE",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565372924",
            "telephone_number": "815-257-0020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST VERNON RESIDENCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-21",
        "last_updated": "2018-09-21",
        "status": "A",
        "authorized_official_last_name": "CLARKSON",
        "authorized_official_first_name": "BETH",
        "authorized_official_middle_name": "ALISON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-257-0020",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dr. Zack D.C. LLC
• Terry A Drake, DDS
• Laura Beth Dubany, LPN
• Kayla Ann Duberowski, PHARM.D.
• Teresa Marie Duoos, RN
• Karen Ranae Ebert, RN
• Blaine Perry Ecker
• Matthew Ecker, CNP
• Peggy Sue Eckert, LPN
• Joann Rae Ehlert, RN

• Foster Care Agency in Fergus Falls, MN
• Providers in Fergus Falls, MN by specialty
• Foster Care Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2018; 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.