Organization
ECUMEN HOME CARE
Active
Other names
The Prairie Lodge at Earle Brown
Organization subpart
No
Provider details
NPI number
Authorized official
KATHRYN R ROBERTS (CEO)
(651) 766-4300
Entity
Organization
Contact information
Practice address
6001 EARLE BROWN DR, BROOKLYN CENTER, MN 55430-2522
(763) 566-1495
Mailing address
3530 LEXINGTON AVE N, SHOREVIEW, MN 55126-8164
(651) 766-4300
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
332750
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4980500
MEDICA
—
01
—
V202864571122603
HEALTHPARTNERS
—
Enumeration date
05/09/2007
Last updated
08/22/2020
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