Organization
MIDWEST GROUP LIVING INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HESEN SHIRE (OWNER)
(612) 222-1111
Entity
Organization
Contact information
Practice address
3552 1ST AVE S, MINNEAPOLIS, MN 55408-4509
(952) 457-3802
(612) 454-2629
Mailing address
415 CEDAR AVE S, MINNEAPOLIS, MN 55454-1011
(952) 457-3802
(612) 454-2629
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
07/11/2018
Last updated
07/11/2018
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