Organization
LIFESPACE COMMUNITIES INC
Active
Parent organization
LIFESPACE COMMUNITIES INC
Other names
Friendship Village of Bloomington
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIFESPACE COMMUNITIES INC
Authorized official
MR. SCOTT MICHAEL HARRISON (PRESIDENT/CEO)
(515) 288-5805
Entity
Organization
Contact information
Practice address
8100 HIGHWOOD DR, BLOOMINGTON, MN 55438-1020
(952) 831-7500
(952) 830-9893
Mailing address
8100 HIGHWOOD DR, BLOOMINGTON, MN 55438-1020
(952) 831-7500
(952) 830-9893
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
332203
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
71-22549
MEDICA
MN
01
—
8773FR
BLUE CROSS BLUE SHIELD
MN
01
—
NH0298
UCARE
MN
Enumeration date
06/12/2006
Last updated
05/04/2010
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