Libra Support Services LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

1041897-1-WS Issued in MN

Legal business name

LIBRA SUPPORT SERVICES LLC

Practice address

29650 Faith CT
Cannon Falls, MN 55009-9439

Phone

(651) 402-9826

Fax

(651) 402-9826

NPI assigned

Oct 9, 2006

Last updated

Jul 21, 2022By 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

Stacy Lynn Luns

Title

President/Owner

Phone

(651) 402-9826

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1700973955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29650 FAITH CT",
            "city": "CANNON FALLS",
            "state": "MN",
            "postal_code": "550099439",
            "telephone_number": "651-402-9826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29650 FAITH CT",
            "city": "CANNON FALLS",
            "state": "MN",
            "postal_code": "550099439",
            "telephone_number": "651-402-9826",
            "fax_number": "651-402-9826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBRA SUPPORT SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "LUNS",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "651-402-9826"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "MN",
            "license": "1041897-1-WS",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN HEALTH CARE PROV-MHCP",
            "identifier": "637683500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Megan Susan Johnston Flanders, MD
• Mark J Juetten, DDS
• Charles M. Kelly II, M.D.
• Kerry K Brown PSYD LP PLC
• Eric Ray Leveille, MD
• Leah Lindbeck, CNP-APRN
• Matthew August Maki, D.C.
• Mayo Clinic Health System-Southeast Minnesota Region (Mayo Clinic Health System-Cannon Falls)
• Mayo Clinic Health System-Southeast Minnesota Region (Mayo Clinic Health System-Cannon Falls)
• Mayo Clinic Health System-Southeast Minnesota Region (Mayo Clinic Health System-Cannon Falls)

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Cannon Falls, MN
• Providers in Cannon Falls, MN by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.