Organization
AMAZING LOVE ELDERLY CARE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PENNY JEAN POLING (OWNER/PARTNER)
(218) 296-1872
Entity
Organization
Contact information
Practice address
7807 EMERALD RD, RANDALL, MN 56475-2428
(320) 749-2485
Mailing address
31 10TH ST NW, STAPLES, MN 56479-5118
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
1083851
MN
Other
Enumeration date
11/03/2016
Last updated
11/03/2016
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