Organization
THE HOMESTEAD AT ANOKA, INC.
Active
Other names
Anoka Rehabilitation and Living Center
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY GAVIN (ASSISTANT SECRETARY)
(612) 428-7840
Entity
Organization
Contact information
Practice address
3000 4TH AVE, ANOKA, MN 55303-1203
(763) 528-6400
(763) 528-6479
Mailing address
7485 OFFICE RIDGE CIR, EDEN PRAIRIE, MN 55344-3690
(952) 941-0305
(952) 941-0428
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
330543
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
261960100
—
MN
01
—
6C77AN
BCBS
MN
01
—
7111783
MEDICA
MN
01
—
92334
HP
MN
01
—
NH0132
U-CARE
MN
Enumeration date
07/21/2006
Last updated
01/12/2021
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