Organization
THE HOMESTEAD AT COON RAPIDS, INC.
Active
Other names
The Homestead at Coon Rapids
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY GAVIN (ASSISTANT SECRETARY/ASSISTANT TREAS)
(952) 983-4249
Entity
Organization
Contact information
Practice address
11372 ROBINSON DR NW, COON RAPIDS, MN 55433-4071
(763) 233-5100
Mailing address
11372 ROBINSON DR NW, COON RAPIDS, MN 55433-4071
(763) 233-5100
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
MN
Enumeration date
02/04/2019
Last updated
02/05/2021
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