Organization
GLENDALOUGH OF AUSTIN, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUSS KENNEDY (CEO)
(507) 334-4347
Entity
Organization
Contact information
Practice address
1409 12TH AVE NW, AUSTIN, MN 55912-1912
(507) 433-6499
Mailing address
402 HERITAGE PL, FARIBAULT, MN 55021-5248
(507) 334-4347
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
804833 2 RS
MN
Other
Enumeration date
11/28/2006
Last updated
08/22/2020
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