Organization
KEYSTONE FIVE STAR LLC
Active
Other names
Keystone Bluffs Assisted Living
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LYNN GEVIK RN (COO)
(218) 625-2316
Entity
Organization
Contact information
Practice address
2528 TRINITY RD, DULUTH, MN 55811-3315
(218) 727-2800
Mailing address
2528 TRINITY RD, DULUTH, MN 55811-3315
(218) 727-2800
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
334218
MN
310400000X
Assisted Living Facility
336667
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
41-1936451
FIRST PLAN OF MINNESOTA
MN
01
—
411936451
MEDICA
MN
01
—
660078000
STATE OF MN PROVIDER #
MN
Enumeration date
03/23/2007
Last updated
07/25/2008
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