Organization
EBENEZER RIDGES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ERIN HILLIGAN (ADMINISTRATOR)
(952) 898-8410
Entity
Organization
Contact information
Practice address
13820 COMMUNITY DR, BURNSVILLE, MN 55337-4519
(952) 898-8400
(952) 898-8450
Mailing address
13820 COMMUNITY DR, BURNSVILLE, MN 55337-4519
(952) 898-8400
(952) 898-8450
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
328249
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
328249
STATE LICENSE
MN
05
—
834243100
—
MN
Enumeration date
08/09/2005
Last updated
02/25/2013
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