Organization
LINO LAKES GW, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH PAULEY (BUSINESS MANAGER)
(651) 287-0265
Entity
Organization
Contact information
Practice address
675 MARKET PLACE DRIVE, LINO LAKES, MN 55014
(651) 287-0265
Mailing address
750 MAIN ST, MENDOTA HEIGHTS, MN 55118-3764
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
372756
MN
Other
Enumeration date
07/10/2015
Last updated
07/10/2015
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