Organization
ESTATES AT EXCELSIOR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA LEGUM (CEO)
(507) 625-8741
Entity
Organization
Contact information
Practice address
515 DIVISION ST, EXCELSIOR, MN 55331-3233
(952) 474-5488
Mailing address
638 SOUTHBEND AVE, MANKATO, MN 56001-2168
(507) 625-8741
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
02/05/2017
Last updated
02/05/2017
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