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KEYSTONE PRIOR LAKE
NPI 1003292962
Assisted Living Facility in Prior Lake, MN

Active since August 03, 2015
4685 PARK NICOLLET AVE SE, PRIOR LAKE, MN 55372(952) 226-9200(952) 226-9201 Get Directions Write a Review

NPPES record last updated: August 3, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Keystone Prior Lake NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KEYSTONE PRIOR LAKE (NPI 1003292962) is a healthcare organization registered as an assisted living facility in Prior Lake, Minnesota and active in the NPI registry since August 2015. The organization lists Ryan Novaczyk, President, as its authorized official.

NPPES Registry Identity

NPI1003292962
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NamePRIOR LAKE OPS LLC
Location Address4685 PARK NICOLLET AVE SEPrior Lake, MN 55372-3926
Mailing Address7625 Golden Triangle Dr, Suite TEden Prairie, MN 55344-3710 · (952) 241-8202
Phone(952) 226-9200
Fax(952) 226-9201
Organization SubpartNo
Authorized OfficialRyan NovaczykPresident · (952) 241-8204
Enumeration DateAugust 3, 2015
✔ NPI 1003292962 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
Definition
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.
4685 PARK NICOLLET AVE SE, Prior Lake, MN 55372
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Other Names 1

Doing Business AsKeystone Prior Lake

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

4685 PARK NICOLLET AVENUE OPCO LLC
Assisted Living Facility
4685 PARK NICOLLET AVE SE
PRIOR LAKE, MN 55372
Scott County (952) 226-9200
KEYSTONE COMMUNITIES OF PRIOR LAKE
Lodging
4685 PARK NICOLLET AVE SE
PRIOR LAKE, MN 55372
Scott County (952) 836-2793
JESSICA LYNN SPURRIER
Nurse Practitioner (Family)
4685 PARK NICOLLET AVE SE
PRIOR LAKE, MN 55372
Scott County (612) 254-9456
KATHERINE PRICE OTR/L
Occupational Therapist
4685 PARK NICOLLET AVE SE
PRIOR LAKE, MN 55372
Scott County (952) 226-9200

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Prior Lake Ops LLC's NPI number?

The NPI number for Prior Lake Ops LLC is 1003292962. It was assigned to this organization in the NPPES registry on August 3, 2015. The provider is doing business as Keystone Prior Lake.

Where is Prior Lake Ops LLC located?

Prior Lake Ops LLC is located at 4685 Park Nicollet Ave SE, Prior Lake, MN 55372. The listed phone number is (952) 226-9200.

What is Prior Lake Ops LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

When was this NPI record last updated?

The NPPES record for Prior Lake Ops LLC was last updated on August 3, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.