Organization
LYNGBLOMSTEN CARE CENTER, INC.
Active
Parent organization
LYNGBLOMSTEN
Other names
Lyngblomsten Care Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
LYNGBLOMSTEN
Authorized official
BRADLEY J. JACOBSON (CFO)
(651) 632-5310
Entity
Organization
Contact information
Practice address
1415 ALMOND AVE, SAINT PAUL, MN 55108-2507
(651) 632-5310
(651) 646-8390
Mailing address
1415 ALMOND AVE, SAINT PAUL, MN 55108-2507
(651) 632-5310
(651) 646-8390
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
332291
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009342400
—
MN
Enumeration date
07/30/2006
Last updated
02/08/2010
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