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Organization

ST. WILLIAM'S LIVING CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. TIM RAY KELLY (ADMINISTRATOR)
(218) 338-1001
Entity
Organization

Contact information

Practice address
212 W SOO ST, PARKERS PRAIRIE, MN 56361-4404
(218) 338-4671
(218) 338-5917
Mailing address
212 W SOO ST, PARKERS PRAIRIE, MN 56361-4404
(218) 338-4671
(218) 338-5917

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
335483
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
887342900
MN
Enumeration date
03/13/2007
Last updated
06/15/2021
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