Organization
ELDERS HOME INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CALVIN BRUCE ANDERSON LNHA (ADMINISTRATOR)
(218) 385-2005
Entity
Organization
Contact information
Practice address
215 S TOUSLEY AVE, NEW YORK MILLS, MN 56567
(218) 385-2005
(218) 385-4170
Mailing address
PO BOX 188, NEW YORK MILLS, MN 56567
(218) 385-2005
(218) 385-4170
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
329990
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7100439
MEDICA
—
01
—
8774EL
BCBS
—
Enumeration date
01/20/2006
Last updated
08/22/2020
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