Organization
ECUMEN
Active
Other names
L.O. Simenstad
Organization subpart
No
Provider details
NPI number
Authorized official
KATHRYN R ROBERTS (CEO)
(651) 766-4300
Entity
Organization
Contact information
Practice address
301 RIVER STREET, OSCEOLA, WI 54020-3024
(715) 294-5641
(715) 294-5785
Mailing address
3530 LEXINGTON AVE N, SHOREVIEW, MN 55126-8164
(651) 766-4300
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2329
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20195600
—
WI
Enumeration date
04/18/2007
Last updated
08/22/2020
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