Organization
LEGACY HOUSE OF CARING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERI KATHLEEN DUBOW (OWNER)
(320) 492-6253
Entity
Organization
Contact information
Practice address
2428 IMPERIAL DR, SAINT CLOUD, MN 56301-5009
(320) 251-2021
Mailing address
540 BROOK LN, SAINT CLOUD, MN 56301-9611
(320) 492-6253
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A502690100
STATE OF MINNESOTA
MN
Enumeration date
02/20/2019
Last updated
02/20/2019
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