Organization
FAIRWAY VIEW OF SENIOR COMMUNITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HOWIE GROFF (PRESIDENT)
(952) 888-2923
Entity
Organization
Contact information
Practice address
215 LUNDELL AVE, ORTONVILLE, MN 56278-4516
(952) 888-2923
Mailing address
215 LUNDELL AVE, ORTONVILLE, MN 56278-4516
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
328664
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050606005
PRIMEWEST
MN
01
—
328664
ALHCP
MN
01
—
329312
HWS
MN
05
—
861473300
—
MN
Enumeration date
04/26/2006
Last updated
06/25/2008
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