Organization
MOUNT OLIVET HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD A ANDERSON (CONTROLLER)
(612) 821-3185
Entity
Organization
Contact information
Practice address
5517 LYNDALE AVE S, MINNEAPOLIS, MN 55419-1719
(612) 827-5677
(612) 821-3241
Mailing address
5517 LYNDALE AVE S, MINNEAPOLIS, MN 55419-1719
(612) 827-5677
(612) 821-3241
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
328408
MN
Other
Enumeration date
07/19/2005
Last updated
08/22/2020
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