Organization
EXTENDICARE HOMES, INC.
Active
Other names
Richfield Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA JO MAASSEN (DIRECTOR OF COMPLIANCE)
(414) 908-8119
Entity
Organization
Contact information
Practice address
7727 PORTLAND AVE, RICHFIELD, MN 55423-4320
(612) 861-1691
(612) 861-0186
Mailing address
111 W MICHIGAN ST, MILWAUKEE, WI 53203-2903
(414) 908-8119
(414) 908-7105
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08034300
—
MN
Enumeration date
11/17/2006
Last updated
03/30/2008
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