Organization
ASSISTED LIVING CONCEPTS INC
Active
Other names
Country Villa
Organization subpart
No
Provider details
NPI number
Authorized official
WALTER A LEVONOWICH (VICE PRESIDENT CONTROLLER)
(262) 257-8888
Entity
Organization
Contact information
Practice address
7475 COUNTRY CLUB DRIVE, GOLDEN VALLEY, MN 55427
(763) 512-1579
(763) 540-6899
Mailing address
W140 N8981 LILLY ROAD, ATTN LEGAL DEPARTMENT, MENOMONEE FALLS, WI 53051-2325
(262) 257-8888
(262) 251-7633
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
HFID204
MN
Other
Enumeration date
05/07/2008
Last updated
05/07/2008
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