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Organization

MARTIN LM LLC

Active
Parent organization
MARTIN LM LLC
Other names
Martin Luther Adult Day Program
Organization subpart
Yes

Provider details

NPI number
Legal business name
MARTIN LM LLC
Authorized official
DENVER KAUFMAN (PRESIDENT)
(612) 371-0053
Entity
Organization

Contact information

Practice address
1401 E 100TH ST, BLOOMINGTON, MN 55425-2615
(952) 948-5154
Mailing address
1401 E 100TH ST, BLOOMINGTON, MN 55425-2615
(952) 948-5154

Taxonomy

Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
640027100
MN
Enumeration date
08/22/2007
Last updated
12/17/2008
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