Organization
LUTHERAN SOCIAL SERVICE OF MINNESOTA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BRIGID PETERSON (CHIEF COMPLIANCE & INTEGRATION)
(651) 310-9451
Entity
Organization
Contact information
Practice address
497 GATES AVE NW, ELK RIVER, MN 55330-2633
(651) 310-9451
Mailing address
2485 COMO AVE, SAINT PAUL, MN 55108-1445
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Enumeration date
01/13/2016
Last updated
01/13/2016
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