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Organization
LEGACY CARE PROVIDERS INC
Active
Organization
LEGACY CARE PROVIDERS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN WILLIAM TAMMEN (VICE PRESIDENT / BILLER)
(320) 847-0617
Entity
Organization
Contact information
Practice address
116 SCHAAF ST, MURDOCK, MN 56271-7995
(320) 875-4742
(320) 875-4555
Mailing address
175 80TH AVE NE, CLARA CITY, MN 56222-1221
(320) 841-0617
(320) 875-4555
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
347574
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
347574
ASSISTED LIVING CLASS F HOME CARE PROVIDER
MN
Enumeration date
01/25/2010
Last updated
01/25/2010
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