Organization
VSSA BOUTWELLS LANDING,LLC
Active
Other names
BOUTWELLS LANDING
Organization subpart
No
Provider details
NPI number
Authorized official
MARK MEYER (CFO)
(651) 631-6120
Entity
Organization
Contact information
Practice address
5600 NORWICH PKWY, OAK PARK HEIGHTS, MN 55082-6482
(651) 275-5000
Mailing address
5600 NORWICH PKWY, OAK PARK HEIGHTS, MN 55082-6482
(651) 275-5000
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
359577
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A926608200
UMPI
MN
Enumeration date
03/12/2014
Last updated
03/12/2014
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