Provider Demographics
NPI:1821570219
Name:WOODBURY OPS, LLC
Entity Type:Organization
Organization Name:WOODBURY OPS, LLC
Other - Org Name:NEW PERSPECTIVE - WOODBURY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CFO
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NOVACZYK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-241-8204
Mailing Address - Street 1:7625 GOLDEN TRIANGLE DR STE T
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-3700
Mailing Address - Country:US
Mailing Address - Phone:952-241-8211
Mailing Address - Fax:952-241-8232
Practice Address - Street 1:2195 CENTURY AVE S
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-2943
Practice Address - Country:US
Practice Address - Phone:651-459-1400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-31
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN387584310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility