Organization
LSI SERVICES, LLC
Active
Other names
Colonial Manor of Balaton
Organization subpart
No
Provider details
NPI number
Authorized official
R. PETER MADEL III (OWNER)
(507) 734-3511
Entity
Organization
Contact information
Practice address
551 US HWY 14, BALATON, MN 56115
(507) 734-3511
(507) 734-2337
Mailing address
PO BOX 219, 551 US HWY 14, BALATON, MN 56115
(507) 734-3511
(507) 734-2337
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
331952
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4743CO
BC
MN
05
—
570014400
—
MN
01
—
NH0252
UCARE
MN
Enumeration date
07/09/2006
Last updated
07/09/2015
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