OrganizationActive
Ebenezer Lakes Assisted Living
NPI 1679916571 · Skilled Nursing Facility · Wyoming, MN
Provider details
- NPI number
- 1679916571
- Entity type
- Organization
- Primary specialty
- Skilled Nursing FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Kari Wilson, Campus Director(651) 982-6228
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
Detailed profile(78/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
25565 Fairview Ave
Wyoming, MN 55092-8053
Phone: (651) 982-6228
Fax: (651) 466-0714
Street-level locationGet directions
Mailing address
25565 Fairview Ave
Wyoming, MN 55092-8053
Other names (DBA / former)
- Doing business as
- Meadows on Fairview
Registry dates
- Enumerated
- 2013-04-10
- Last updated
- 2016-12-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.