Organization
MCINTOSH SENIOR LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARLENE KNUTSON (ADMINISTRATOR)
(218) 563-2715
Entity
Organization
Contact information
Practice address
600 RIVERSIDE AVE NE, MCINTOSH, MN 56556-5750
(218) 563-2715
(218) 563-2395
Mailing address
600 RIVERSIDE AVE NE, MCINTOSH, MN 56556-5750
(218) 563-2715
(218) 563-2395
Taxonomy
Speciality
Code
Description
License number
State
311500000X
Alzheimer Center (Dementia Center)
346410
MN
314000000X
Skilled Nursing Facility
Primary
346410
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
230080000
—
MN
Enumeration date
09/25/2009
Last updated
10/15/2019
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