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Organization

CENTRAL MINNESOTA SENIOR CARE, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DEBRA JOANNE SHRIVER (CEO)
(320) 231-2738
Entity
Organization

Contact information

Practice address
328 5TH ST SW, WILLMAR, MN 56201-3200
(320) 231-2738
Mailing address
328 5TH ST SW, WILLMAR, MN 56201-3200
(320) 231-2738

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
434214300
MN
311Z00000X
Custodial Care Facility
402971200
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
040911002
PRIMEWEST
MN
05
402971200
MN
05
434214300
MN
01
5982222
MEDICA
MN
Enumeration date
02/06/2007
Last updated
06/16/2008
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