Organization
ESTATES AT ST LOUIS PARK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA LEGUM (CEO)
(597) 625-8741
Entity
Organization
Contact information
Practice address
3201 VIRGINIA AVE S, ST LOUIS PARK, MN 55426-3624
(952) 935-0333
Mailing address
638 SOUTHBEND AVE, MANKATO, MN 56001-2168
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
02/06/2017
Last updated
02/06/2017
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