Organization
ECUMEN
Active
Other names
Ecumen Lakeshore
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS HARRISON (CFO)
(651) 766-4300
Entity
Organization
Contact information
Practice address
4002 LONDON RD, DULUTH, MN 55804-2243
(218) 625-7825
Mailing address
4002 LONDON RD, DULUTH, MN 55804-2243
(218) 625-7825
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
332007
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001043000
—
MN
01
—
7122649
MEDICA
—
01
—
8614LA
BCBS
MN
01
—
NH0212
UCARE
—
Enumeration date
03/16/2007
Last updated
04/22/2026
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