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Organization
KEYSTONE FIVE STAR LLC
Active
Organization
KEYSTONE FIVE STAR LLC
Active
Other names
Keystone Bluffs Assisted Living
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LYNN GEVIK RN (COO)
(218) 625-2316
Entity
Organization
Contact information
Practice address
2528 TRINITY RD, DULUTH, MN 55811-3315
(218) 727-2800
Mailing address
2528 TRINITY RD, DULUTH, MN 55811-3315
(218) 727-2800
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
334218
MN
310400000X
Assisted Living Facility
336667
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
41-1936451
FIRST PLAN OF MINNESOTA
MN
01
—
411936451
MEDICA
MN
01
—
660078000
STATE OF MN PROVIDER #
MN
Enumeration date
03/23/2007
Last updated
07/25/2008
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