Organization
KTJ 292, LLC
Active
Other names
Pillars of Prospect Park
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA BOLLIG (EXECUTIVE DIRECTOR)
(612) 623-7000
Entity
Organization
Contact information
Practice address
22 MALCOLM AVE SE, MINNEAPOLIS, MN 55414-7584
(612) 723-7000
Mailing address
22 MALCOLM AVE SE, MINNEAPOLIS, MN 55414-7584
(612) 723-7000
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
04/30/2020
Last updated
04/30/2020
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