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Organization
PHS-WHITE BEAR LAKE LLC
Active
Organization
PHS-WHITE BEAR LAKE LLC
Active
Other names
Harbor Crossing
Organization subpart
No
Provider details
NPI number
Authorized official
JON TRANBY (PAYER RELATIONS DIRECTOR)
(651) 631-6102
Entity
Organization
Contact information
Practice address
4650 CENTERVILLE RD, WHITE BEAR LAKE, MN 55127-3200
(651) 631-6100
(651) 631-6122
Mailing address
2845 HAMLINE AVE N, ROSEVILLE, MN 55113-7127
(651) 631-6432
(651) 631-6122
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
03/04/2022
Last updated
08/18/2026
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