Organization
KEYSTONE COMMUNITIES OF PRIOR LAKE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA TEFF (ACCOUNTS SUPERVISOR)
(952) 836-2793
Entity
Organization
Contact information
Practice address
4685 PARK NICOLLET AVE SE, PRIOR LAKE, MN 55372-3926
(952) 836-2793
Mailing address
4685 PARK NICOLLET AVE SE, PRIOR LAKE, MN 55372-3926
Taxonomy
Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
Primary
333604
MN
Other
Enumeration date
12/28/2006
Last updated
08/22/2020
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