Organization
FIVE STAR LIVING OF BRAINERD, LLC
Active
Other names
Diamond Willow
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LYNN GEVIK R.N. (COO)
(218) 625-2316
Entity
Organization
Contact information
Practice address
14396 GRAND OAKS DR, BAXTER, MN 56425
(218) 625-2316
(218) 727-9559
Mailing address
11 E SUPERIOR ST, SUITE 508, DULUTH, MN 55802-2007
(218) 625-2316
(218) 727-9559
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
332934
MN
Other
Enumeration date
02/27/2007
Last updated
08/22/2020
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