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Organization

AVIV HEALTH CARE, INC.

Active
Other names
BRYN MAWR HEALTH CARE CENTER
Organization subpart
No

Provider details

NPI number
Authorized official
MR. TONY PASELL (COMPTROLLER)
(952) 259-5222
Entity
Organization

Contact information

Practice address
275 PENN AVE N, MINNEAPOLIS, MN 55405-1216
(612) 377-4723
(612) 377-0294
Mailing address
4509 MINNETONKA BLVD, ST LOUIS PARK, MN 55416-4027
(952) 259-5224
(952) 920-5207

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
327079
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30329
ND
01
7100254
MEDICA
MN
01
7122599
MEDICA
MN
01
8711BR
BLUE CROSS BLUE SHIELD
MN
01
NH0006
UCARE
MN
Enumeration date
09/15/2005
Last updated
08/22/2020
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