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Organization

KTJ 212, LLC

Active
Other names
Shorewood Landing Senior Living
Organization subpart
No

Provider details

NPI number
Authorized official
LISA MISKULIN (EXECUTIVE DIRECTOR)
(952) 401-7444
Entity
Organization

Contact information

Practice address
6000 CHASKA RD, EXCELSIOR, MN 55331-3173
(952) 401-7444
Mailing address
6000 CHASKA RD, EXCELSIOR, MN 55331-3173
(952) 401-7444

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary

Other

Enumeration date
04/29/2019
Last updated
04/29/2019
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