Organization
VILLAGE OF FERTILE
Active
Other names
Fair Meadow Nursing Home
Organization subpart
No
Provider details
NPI number
Authorized official
LISA JOY LIDEN (CITY ADMINISTRATOR)
(218) 945-6194
Entity
Organization
Contact information
Practice address
300 GARFIELD AVE. SE, FERTILE, MN 56540-0008
(218) 945-6194
(218) 945-6459
Mailing address
PO BOX 8, 300 GARFIELD AVE. SE, FERTILE, MN 56540-0008
(218) 945-6194
(218) 945-6459
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
327713
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4541FA
BLUE CROSS/BLUE SHIELD
MN
05
—
804740500
—
MN
Enumeration date
05/23/2005
Last updated
12/13/2023
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