Organization
ECUMEN
Active
Other names
The Evergreens of Fargo-1411
Organization subpart
No
Provider details
NPI number
Authorized official
KATHRYN R ROBERTS (CEO/PRESIDENT)
(651) 766-4300
Entity
Organization
Contact information
Practice address
3530 LEXINGTON AVE N, SHOREVIEW, MN 55126-8166
(651) 766-4300
Mailing address
3530 LEXINGTON AVE N, SHOREVIEW, MN 55126-8166
(651) 766-4300
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
08/07/2015
Last updated
08/07/2015
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