# WAVERLY SENIOR LIVING LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548139751
- **Authorized official:** RONAK PATEL (MANAGER)
- **Authorized official phone:** (847) 370-6328

## Contact information

- **Practice address:** 105 PLUM RUN, LE SUEUR, MN 56058-2188
- **Practice address phone:** (847) 370-6328
- **Mailing address:** 105 PLUM RUN, LE SUEUR, MN 56058-2188

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 376K00000X | Nurse's Aide | — | NULL | Yes |
| 376K00000X | Nurse's Aide | — | — | Yes |

## Other

- **Enumeration date:** 11/04/2025
- **Last updated:** 11/04/2025