Organization
FAULKNER AND REYNOLDS ENTERPRISES, INC
Active
Other names
Hayes Residence
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA REYNOLDS ADMINISTRATOR (ADMINISTRATOR/OWNER)
(651) 690-4458
Entity
Organization
Contact information
Practice address
1620 RANDOLPH AVE, ST. PAUL, MN 55105
(651) 690-4458
(651) 690-2787
Mailing address
1620 RANDOLPH AVE, ST. PAUL, MN 55105
(651) 690-4458
(651) 690-2787
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
327672
MN
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
360749
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
314243400
—
MN
Enumeration date
11/08/2005
Last updated
02/12/2013
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