Organization
SHP V WSLG PLYMOUTH LLC
Active
Other names
The Waters of Plymouth
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN BLAZEJEWSKI (PRESIDENT)
(404) 704-3789
Entity
Organization
Contact information
Practice address
11305 HIGHWAY 55, PLYMOUTH, MN 55441-6035
(763) 270-5220
Mailing address
3348 PEACHTREE RD NE STE 1100, ATLANTA, GA 30326-1447
(404) 704-3789
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
06/22/2021
Last updated
06/22/2021
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