KEYSTONE FIVE STAR LLC (NPI# 1518084847) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518084847 |
| Entity Type | Organization |
| Organization Name | KEYSTONE FIVE STAR LLC |
| Other Organization Name | KEYSTONE BLUFFS ASSISTED LIVING |
| Practice Address |
2528 Trinity Rd Duluth MN 55811-3315 |
| Practice Telephone | 2187272800 |
| Mailing Telephone | 2187272800 |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2008-07-25 |
| Authorized Official Name | MS. LYNN GEVIK (COO) |
| Authorized Official Telephone | 2186252316 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 310400000X | Assisted Living Facility | 336667 | MN | Nursing & Custodial Care Facilities |
| Y | 310400000X | Assisted Living Facility | 334218 | MN | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | FIRST PLAN OF MINNESOTA | 41-1936451 | 01 |
| MN | MEDICA | 411936451 | 01 |
| MN | STATE OF MN PROVIDER # | 660078000 | 01 |
| Other Name | Type Code |
|---|---|
| Keystone Bluffs Assisted Living | Doing Business As Name - Organization |
| Street Address |
2528 TRINITY RD |
| City | DULUTH |
| State | MN |
| Zip Code | 55811-3315 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497152623 | Fcsl - Keystone Bluffs, LLC | Assisted Living Facility | 2528 Trinity Rd, Duluth, MN 55811-3315 | 2014-12-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417515339 | Kyle Olson-merrick | Dentist | 320 W Myrtle St, Ste 100, Duluth, MN 55811 | 2019-06-05 |
| 1184288979 | Pdg, P.a. | Clinic/Center | 4891 Miller Truck Hwy., Suite 100, Hermantown, MN 55811 | 2019-04-26 |
| 1528589843 | Breanna Joy Greenly | Counselor | 4720 Burning Tree Road, Birch Tree Center, Duluth, MN 55811 | 2017-06-28 |
| 1396102398 | Debbie Christian | Registered Nurse | 4815 Burning Tree Rd Suite 100, Duluth, MN 55811 | 2016-01-21 |
| 1831556935 | Megan Marie Paris | Psychologist | 715 East Central Entrance, Duluth, MN 55811 | 2016-01-20 |
| 1740666908 | Angela Fedo | Physical Therapy Assistant | 2101 Trinity Rd, Duluth, MN 55811 | 2015-08-10 |
| 1649657479 | Kayla Stephenson | Specialist/Technologist | 5024 Morris Thomas Road, Hermantown, MN 55811 | 2015-04-30 |
| 1073918843 | Northern Lives Inc. | Assisted Living Facility | 4014 Trinity Road, Duluth, MN 55811 | 2014-10-23 |
| 1114326238 | Donald Hermanson | Specialist/Technologist | 801 Boulder Drive, Apt. 202, Duluth, MN 55811 | 2014-08-14 |
| 1679990857 | Jodie Little | Pharmacist | 801 W. Central Entrance, Shopko Pharmacy 2114, Duluth, MN 55811 | 2014-03-25 |
| Find all providers in zip 55811 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184195968 | Tender Cares LLC | Assisted Living Facility | 1137 Brainerd Ave, Duluth, MN 55811-4913 | 2018-12-05 |
| 1144628231 | Fcsl Lester Park, LLC | Assisted Living Facility | 6355 E Superior St, Duluth, MN 55804-2545 | 2014-12-05 |
| 1710384862 | Fcsl Lester Park, LLC | Assisted Living Facility | 6353 E Superior St, Duluth, MN 55804-2545 | 2014-12-04 |
| 1073918843 | Northern Lives Inc. | Assisted Living Facility | 4014 Trinity Road, Duluth, MN 55811 | 2014-10-23 |
| 1649521444 | Benedictine Sisters Benevolent Association | Assisted Living Facility | 1001 Kenwood Ave, Duluth, MN 55811-2370 | 2012-09-20 |
| 1780939132 | Five Star Assisted Living Services, LLC | Assisted Living Facility | 6353 E Superior Street, Duluth, MN 55804-2545 | 2012-07-20 |
| 1962676577 | St. Ann's Home | Assisted Living Facility | 330 E 3rd St, Duluth, MN 55805-1846 | 2008-04-15 |
| 1093999773 | River Hill Assisted Living, Inc. | Assisted Living Facility | 126 98 Ave West, Duluth, MN 55808-2110 | 2007-12-18 |
| 1396959433 | Heritage Haven Inc | Assisted Living Facility | 4512 London Rd, Duluth, MN 55804-2340 | 2007-05-09 |
| 1043398274 | St. Francis Health Services of Morris, Inc | Assisted Living Facility | 50 E Saint Marie St, Duluth, MN 55803-2634 | 2006-11-02 |
| Find all providers in DULUTH | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.