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Organization
ILHC OF EAGAN, LLC
Active
Organization
ILHC OF EAGAN, LLC
Active
Other names
THE COMMONS ON MARICE
Organization subpart
No
Provider details
NPI number
Authorized official
MISS DENISE GUSTAFSON (PRESIDENT)
(952) 361-8000
Entity
Organization
Contact information
Practice address
1380 MARICE DR, EAGAN, MN 55121-9748
(651) 688-9999
(651) 688-7888
Mailing address
1107 HAZELTINE BLVD, SUITE 200, CHASKA, MN 55318-1009
(952) 361-8000
(952) 361-8058
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
329867
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
344718900
—
MN
Enumeration date
06/09/2006
Last updated
07/11/2008
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