Organization
RIDGEWOOD MANOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY M PETERSEN (PARTNER)
(763) 607-6874
Entity
Organization
Contact information
Practice address
10038 215TH AVE NW, ELK RIVER, MN 55330-8519
(763) 607-6874
(267) 350-9164
Mailing address
10038 215TH AVE NW, ELK RIVER, MN 55330-8519
(763) 607-6874
(267) 350-9164
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
1066808-1-AFC
MN
Other
Enumeration date
08/22/2013
Last updated
08/22/2013
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