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Organization

DELOUGHERY HOME LIMITED PARTNERSHIP

Active
Other names
Lewiston Villa Nursing Home
Organization subpart
No

Provider details

NPI number
Authorized official
BOB LIEBIG (PARTNER)
(651) 483-2586
Entity
Organization

Contact information

Practice address
505 E MAIN ST, LEWISTON, MN 55952-1204
(507) 523-2123
(507) 523-3699
Mailing address
505 E MAIN ST, LEWISTON, MN 55952-1204
(507) 523-2123
(507) 523-3699

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
328692
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
9138LE
BCBS MN
MN
Enumeration date
06/13/2005
Last updated
08/22/2020
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