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Organization
EDGEWOOD HERMANTOWN II SENIOR LIVING LLC
Active
Organization
EDGEWOOD HERMANTOWN II SENIOR LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RON WHETTER (VP BUDGET AND FINANCE)
(701) 738-2000
Entity
Organization
Contact information
Practice address
4125 WESTBERG RD, HERMANTOWN, MN 55811-3923
(701) 738-2000
(701) 738-2001
Mailing address
2850 24TH AVE S, SUITE 201, GRAND FORKS, ND 58201-5831
(701) 738-2000
(701) 738-2001
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
338365
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
338365
—
MN
Enumeration date
12/28/2007
Last updated
05/26/2011
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