Organization
MARTIN LM LLC
Active
Parent organization
MARTIN LM LLC
Other names
Martin Luther Care Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
MARTIN LM LLC
Authorized official
DENVER KAUFMAN (PRESIDENT)
(612) 371-0053
Entity
Organization
Contact information
Practice address
1401 E 100TH ST, BLOOMINGTON, MN 55425
(952) 888-7751
(952) 698-3626
Mailing address
1401 E 100TH ST, BLOOMINGTON, MN 55425
(952) 888-7751
(952) 698-3626
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
343053
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
180482000
—
MN
01
—
71-22647
MEDICA
MN
01
—
8606MA
BLUE CROSS BLUE SHIELD
MN
01
—
NH0033
UCARE
MN
Enumeration date
11/08/2006
Last updated
08/03/2009
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