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Organization
EVANS PARK, INC
Active
Organization
EVANS PARK, INC
Active
Parent organization
EVANS PARK, INC.
Other names
Guardian Angels By The Lake
Organization subpart
Yes
Provider details
NPI number
Legal business name
EVANS PARK, INC.
Authorized official
TROY HANSON (VP, CFO)
(763) 241-4445
Entity
Organization
Contact information
Practice address
13439 185TH LN NW, ELK RIVER, MN 55330-2713
(763) 241-7682
Mailing address
508 FREEPORT AVE NW STE A, ELK RIVER, MN 55330-1874
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A634929300
MN DEPARTMENT OF HUMAN SERVICES
MN
Enumeration date
05/15/2018
Last updated
05/15/2018
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