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Organization

STEVE & BARB JENSEN

Active
Other names
Your Home at the Lake
Organization subpart
No

Provider details

NPI number
Authorized official
BARBARA JENSEN (OWNER)
(218) 495-2625
Entity
Organization

Contact information

Practice address
36309 AUGUSTANA DR, BATTLE LAKE, MN 56515-9361
(218) 495-2625
(218) 736-4250
Mailing address
36309 AUGUSTANA DR, BATTLE LAKE, MN 56515-9361
(218) 495-2625
(218) 736-4250

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A356977000
MN UMIP
MN
Enumeration date
12/10/2015
Last updated
12/10/2015
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