Healthcare Provider Details

I. General information

NPI: 1417892464
Provider Name (Legal Business Name): APPLE VALLEY OPERATIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2026
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14625 PENNOCK AVE
APPLE VALLEY MN
55124-3502
US

IV. Provider business mailing address

8170 MCCORMICK BLVD STE 112
SKOKIE IL
60076-2914
US

V. Phone/Fax

Practice location:
  • Phone: 773-825-3336
  • Fax:
Mailing address:
  • Phone: 773-825-3336
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: MAX STESEL
Title or Position: MANAGER
Credential:
Phone: 773-825-3336