Organization
EDAN OAK LLC
Active
Organization
EDAN OAK LLC
Active
Other names
Edan Oak assisted living
Organization subpart
No
Provider details
NPI number
Authorized official
SANDOL KHALAF (OWNER)
(612) 644-0643
Entity
Organization
Contact information
Practice address
6216 BAKER RD, EDEN PRAIRIE, MN 55346-1928
(612) 644-0643
Mailing address
7400 CEDAR AVE S, MINNEAPOLIS, MN 55423-4647
(612) 644-0643
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
—
—
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
—
—
Other
Enumeration date
05/20/2025
Last updated
05/20/2025
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