Organization
PHS WALNUT RIDGE LLC
Active
Other names
PHS Walnut Ridge LLC., Walnut Ridge
Organization subpart
No
Provider details
NPI number
Authorized official
MARK T MEYER (CFO)
(651) 631-6102
Entity
Organization
Contact information
Practice address
1703 CAMPUS DRIVE, CLIVE, IA 50325
(651) 631-6450
(651) 631-6122
Mailing address
2845 HAMLINE AVE N, ROSEVILLE, MN 55113-7127
(651) 631-6432
(651) 631-6122
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
09/05/2019
Last updated
11/11/2025
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