Organization
SELECT SENIOR LIVING OF COON RAPIDS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY J MYERS (RESIDENCE DIRECTOR)
(651) 492-6535
Entity
Organization
Contact information
Practice address
11350 MARTIN ST NW, COON RAPIDS, MN 55433-3988
(763) 767-1127
(651) 455-0267
Mailing address
11350 MARTIN ST NW, COON RAPIDS, MN 55433-3988
(763) 767-1127
(651) 455-0267
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
339176
MN
Other
Enumeration date
04/18/2008
Last updated
04/18/2008
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