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Organization

LEGACY SENIOR SERVICES

Active
Other names
Frazee Care Center
Organization subpart
No

Provider details

NPI number
Authorized official
ERIC R LUNDE (PRESIDENT)
(612) 695-5618
Entity
Organization

Contact information

Practice address
219 W MAPLE AVE, FRAZEE, MN 56544-4346
(218) 334-4501
Mailing address
PO BOX 96, FRAZEE, MN 56544-0096
(218) 334-4501
(218) 334-4500

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
337844
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4980495
MEDICA WAIVER
MN
01
5L06FR
BLUECROSS BLUESHIELD
MN
01
7100395
MEDICA MSHO
MN
01
7122681
MEDICA INSURANCE
MN
01
80314
UNICARE
MN
05
972153000
MN
Enumeration date
10/31/2007
Last updated
11/28/2023
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