Organization
BETHESDA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALANA SUE ZIEHL (DIRECTOR OF ACCOUNTING)
(320) 235-9532
Entity
Organization
Contact information
Practice address
901 WILLMAR AVE SE, WILLMAR, MN 56201-4604
(320) 235-9532
(320) 235-7909
Mailing address
901 WILLMAR AVE SE, WILLMAR, MN 56201-4604
(320) 235-9532
(320) 235-7909
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
326721
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
516240800
—
MN
01
—
9539BE
BCBS & BLUE PLUS
MN
Enumeration date
06/01/2005
Last updated
03/23/2010
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