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Organization
GOPHER (MAPLE GROVE) TRS LLC
Active
Organization
GOPHER (MAPLE GROVE) TRS LLC
Active
Other names
Havenwood of Maple Glen
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA SIMS (PRESIDENT)
(214) 754-8623
Entity
Organization
Contact information
Practice address
18695 73RD AVE N, MAPLE GROVE, MN 55311-6604
(763) 363-8640
Mailing address
18695 73RD AVE N, MAPLE GROVE, MN 55311-6604
(763) 363-8640
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
01/12/2022
Last updated
01/12/2022
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