Organization
MARTIN LM LLC
Active
Parent organization
MARTIN LM LLC
Other names
Highland House
Organization subpart
Yes
Provider details
NPI number
Legal business name
MARTIN LM LLC
Authorized official
DENVER KAUFMAN (PRESIDENT)
(612) 371-0053
Entity
Organization
Contact information
Practice address
4616 W 102ND ST, BLOOMINGTON, MN 55437-2612
(952) 893-9078
Mailing address
1401 E 100TH ST, BLOOMINGTON, MN 55425-2615
(952) 888-7751
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
1045533-1
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
228487000
—
MN
Enumeration date
08/16/2007
Last updated
12/17/2008
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