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Organization

FIVE STAR LIVING OF CLOQUET, LLC

Active
Other names
Diamond Willow
Organization subpart
No

Provider details

NPI number
Authorized official
LYNN GEVIK RN (COO)
(218) 625-2316
Entity
Organization

Contact information

Practice address
130 WEST NORTH RD, CLOQUET, MN 55720
(218) 625-2316
(218) 625-2338
Mailing address
11 E SUPERIOR ST, SUITE 508, DULUTH, MN 55802-2007
(218) 625-2316
(218) 625-2338

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
332935
MN

Other

Enumeration date
04/11/2007
Last updated
08/22/2020
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