Organization
COUNTRY LIVING MANAGEMENT COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUANNE GIBSON (CEO)
32026990001
Entity
Organization
Contact information
Practice address
4000 COUNTY ROAD 15 SW, MONTEVIDEO, MN 56265-4005
(320) 269-9000
(320) 269-8008
Mailing address
12335 13TH ST NW, SPICER, MN 56288-9316
(320) 269-9000
(320) 269-8008
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
360364
MN
Other
Enumeration date
02/25/2013
Last updated
02/25/2013
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