MEADOWS ON FAIRVIEW
NPI 1134441827
Assisted Living Facility in Wyoming, MN

Q: What is Ebenezer Lakes Assisted Living's NPI number?

The NPI number for Ebenezer Lakes Assisted Living is 1134441827. It was assigned to this organization in the NPPES registry on February 22, 2010. The provider is doing business as Meadows On Fairview.

Q: What is Ebenezer Lakes Assisted Living's specialty?

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

Q: What quality rating does Ebenezer Lakes Assisted Living have?

CMS rates Meadows On Fairview 5 out of 5 stars overall on Care Compare. The full measure detail is in the Nursing Home Quality Ratings section above.

Active since February 22, 2010CLIA 24D1032350 · Waiver

5/5

Overall Rating

25565 FAIRVIEW AVE, WYOMING, MN 55092(651) 982-6228(651) 466-0714 Get Directions Write a Review

NPPES record last updated: February 22, 2010. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Meadows On Fairview NPPES

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

MEADOWS ON FAIRVIEW (NPI 1134441827) is a healthcare organization registered as an assisted living facility in Wyoming, Minnesota and active in the NPI registry since February 2010. The organization holds a CLIA Waiver certificate valid through October 20, 2026 and lists Kari Beth Wilson, Campus Manager, as its authorized official.

NPPES Registry Identity

NPI1134441827

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NameEBENEZER LAKES ASSISTED LIVING

Location Address25565 FAIRVIEW AVEWyoming, MN 55092-8053

Mailing Address25565 Fairview AveWyoming, MN 55092-8053 · (651) 982-6228 · Fax (651) 466-0714

Phone(651) 982-6228

Fax(651) 466-0714

Organization SubpartNo

Authorized OfficialKari Beth WilsonCampus Manager · (651) 982-6228

Enumeration DateFebruary 22, 2010

✔ NPI 1134441827 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities

Taxonomy Code310400000X

License✔ Licensed in MN · 345526

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.

25565 FAIRVIEW AVE, Wyoming, MN 55092

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Other Names 1

Doing Business AsMeadows On Fairview

Other Identifiers 1

Medicare UPINA660928700MN

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 24D1032350

Meadows On Fairview Ebenezer Lakes Assisted Living · Wyoming, MN

Active · expires Oct 20, 2026

CLIA Number24D1032350

Laboratory TypeAssisted Living Facility

Certificate Effective DateOctober 21, 2024

Certificate Expiration DateOctober 20, 2026

Laboratory DirectorGretchen Blaufuss

Laboratory Phone(651) 982-6228

Laboratory LocationMeadows On Fairview Ebenezer Lakes Assisted Living25565 Fairview Avenue, Wyoming, MN 55092

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Nursing Home Quality Ratings CMS Care Compare

Quality ratings, staffing and inspection history for Meadows On Fairview (CMS certification number 245622), from CMS Care Compare.

Meadows On Fairview

Nursing home · Wyoming, MN

5/5 CMS Overall Rating

OwnershipNon profit - Corporation

CMS Certification Number245622

Certified Beds14 beds12 residents per day on average

Medicare & Medicaid Participant SinceDecember 23, 2014

Resident & Family CouncilResident and family councils

Automatic sprinkler system

CMS Star Ratings

Quality Measures

Based on a select set of clinical quality measures.

4/5

Short-Stay Quality

Quality of care delivered to short-term and rehabilitation residents.

4/5

Staffing

Based on nursing staff hours relative to resident needs.

5/5

Weighted Health Inspection Score

Lower scores are better; the score summarizes deficiencies found on recent inspections.

Ratings are assigned by CMS on a one-to-five star scale; five is the highest. Categories without a current CMS rating are not shown.

Staffing & Turnover

Total Nurse Staffing

nurse aide 3.2 · LPN 1.79 · RN 2.26

7.25 hrs per resident per day

Weekend Nurse Staffing

6.55 hrs per resident per day

Physical Therapist Staffing

0.37 hrs per resident per day

Nursing Staff Turnover

Share of nursing staff who left the facility within the past year.

35.5%

Registered Nurse Turnover

33.3%

Administrators Who Have Left

In the past year.

Higher staffing hours generally allow more direct care time per resident.

Inspections & Enforcement

Facility-Reported Incidents

Substantiated Complaints

Fines

Medicare Payment Denials

Total Penalties

Counts come from CMS inspections and complaint investigations over approximately the past three years. CMS Care Compare data as of October 1, 2024.

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Other Providers at the Same Location NPPES 5

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

ANN HERMAN

Physical Therapist