Organization
KTJ 270 LLC
Active
Other names
White Bear Heights
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JACKIE JUAN (EXECUTIVE DIRECTOR)
(651) 653-3288
Entity
Organization
Contact information
Practice address
4650 CENTERVILLE RD, SAINT PAUL, MN 55127-2301
(651) 653-3288
Mailing address
4650 CENTERVILLE RD, SAINT PAUL, MN 55127-2301
(651) 653-3288
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
32991
MN
Other
Enumeration date
04/11/2017
Last updated
04/11/2017
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