Organization
GLENWOOD VILLAGE CARE CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARNIE MARIE GUGISBERG (CFO)
(320) 763-1164
Entity
Organization
Contact information
Practice address
719 2ND ST SE, GLENWOOD, MN 56334-1810
(320) 634-5131
(320) 634-5777
Mailing address
719 2ND ST SE, GLENWOOD, MN 56334-1810
(320) 634-5131
(320) 634-5777
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
030913090
PRIMEWEST
MN
01
—
0309130901
PRIMEWEST
MN
01
—
71-22756
MEDICA
MN
05
—
938342500
—
MN
01
—
9622GL
BLUE CROSS OF MN
MN
Enumeration date
09/29/2005
Last updated
04/12/2024
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