Organization
NU HORIZONS OF SOUTHERN MN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER THOMAS JOHNSON (EXECUTIVE DIRECTOR)
(612) 386-8743
Entity
Organization
Contact information
Practice address
107 PARK AVE NE, ELYSIAN, MN 56028-2041
(612) 386-8743
Mailing address
PO BOX 247, ELYSIAN, MN 56028-0247
(612) 386-8743
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
A016698200
—
MN
05
—
A104640100
—
MN
05
—
A193658000
—
MN
05
—
A399148000
—
MN
05
—
A421408000
—
MN
05
—
A497458400
—
MN
05
—
A722960500
—
MN
05
—
A808132000
—
MN
05
—
A847930100
—
MN
05
—
A851678300
—
MN
05
—
M296987300
—
MN
Enumeration date
08/19/2021
Last updated
08/19/2021
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