Faribault Ops LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

FARIBAULT OPS LLC

Doing business as

Keystone Faribualt

Practice address

828 1St St NE
Faribault, MN 55021-5438

Phone

(507) 332-2555

Fax

(507) 332-9010

NPI assigned

Aug 3, 2015

Last updated

Aug 3, 2015By 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

Ryan Novaczyk

Title

President

Phone

(952) 241-8204

Specialties & licenses 1

Addresses

Other names 1

• Keystone Faribualt Doing business as

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

{
    "created_epoch": "1438560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438560000000",
    "number": "1902282866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7625 GOLDEN TRIANGLE DR",
            "address_2": "SUITE T",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553443710",
            "telephone_number": "952-241-8202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "828 1ST ST NE",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550215438",
            "telephone_number": "507-332-2555",
            "fax_number": "507-332-9010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FARIBAULT OPS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-03",
        "last_updated": "2015-08-03",
        "status": "A",
        "authorized_official_last_name": "NOVACZYK",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "952-241-8204"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Keystone Faribualt",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Faribault Psychological Services PA
• Faribault Rehabilitation Center
• Faribault Senior Living LLC
• Faribault Wellness Center, P.a.
• Annika Ferber, ATC

• 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 Aug 3, 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.