Organization
CAMILIA ROSE GROUP HOME
Active
Other names
MARY T ASSOCIATES
Organization subpart
No
Provider details
NPI number
Authorized official
CONNIE WINBAUER (CONTROLLER)
(763) 862-5436
Entity
Organization
Contact information
Practice address
1555 118TH LN NW, COON RAPIDS, MN 55448-7579
(763) 862-5436
(763) 754-0332
Mailing address
1555 118TH LN NW, COON RAPIDS, MN 55448-7579
(763) 862-5436
(763) 754-0332
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
1075259
MN
Other
Enumeration date
02/07/2007
Last updated
08/22/2020
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