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Organization
PRIMETIME LIVING
Active
Organization
PRIMETIME LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AISHA KASSIM (CHIEF ADMINSTRATIVE OFFICER)
(507) 258-5071
Entity
Organization
Contact information
Practice address
105 N BROADWAY, ROCHESTER, MN 55906-3720
(507) 258-5071
Mailing address
105 N BROADWAY, ROCHESTER, MN 55906-3720
(507) 258-5071
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
364415
MN
Other
Enumeration date
08/19/2014
Last updated
08/19/2014
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