Organization
EDGEWOOD HERMANTOWN 1 SENIOR LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RON WHETTER (VP OF FINANCE/BUDGET)
(701) 757-5465
Entity
Organization
Contact information
Practice address
4175 WESTBERG RD, HERMANTOWN, MN 55811-3916
(218) 723-8905
(218) 723-4051
Mailing address
322 DEMERS AVE, SUITE 500, GRAND FORKS, ND 58201-4754
(701) 757-5465
(701) 738-2001
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
363096
MN
Other
Enumeration date
06/20/2014
Last updated
06/20/2014
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