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Organization
BETHANY BOARD AND LODGE, INC
Active
Organization
BETHANY BOARD AND LODGE, INC
Active
Other names
Riverside Customized Living
Organization subpart
No
Provider details
NPI number
Authorized official
TYLER MCGLYNN (PRESIDENT)
(218) 280-1609
Entity
Organization
Contact information
Practice address
240 1ST ST NE, MCINTOSH, MN 56556
(218) 435-1044
(218) 435-1143
Mailing address
PO BOX 28, FOSSTON, MN 56542
(218) 435-1044
(218) 435-1143
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
11/27/2018
Last updated
11/27/2018
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