Organization
ECUMEN
Active
Other names
Ecumen Scenic Shores
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT RIDDLE (VP OF FINANCE)
(651) 766-4366
Entity
Organization
Contact information
Practice address
402 13TH AVE, TWO HARBORS, MN 55616-1267
(218) 834-8374
(218) 834-8439
Mailing address
402 13TH AVE, TWO HARBORS, MN 55616-1267
(218) 834-8374
(218) 834-8439
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
331615
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
048540300
—
MN
01
—
0Z72LA
BCBS OF MINNESOTA
MN
01
—
140001
FIRST PLAN OF MINNESOTA
MN
Enumeration date
05/27/2006
Last updated
06/03/2011
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