Organization
PHS/LAKE MINNETONKA, LLC
Active
Other names
Lake Minnetonka Shores
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK MEYER (CFO)
(651) 631-6102
Entity
Organization
Contact information
Practice address
4527 SHORELINE DR, SPRING PARK, MN 55384-8706
(952) 471-4000
Mailing address
2845 HAMLINE AVE N, ROSEVILLE, MN 55113-7127
(651) 631-6432
(651) 631-6122
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
357277
MN
Other
Enumeration date
02/13/2014
Last updated
11/11/2025
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