Organization
SENIOR CARE WOODBURY, LLC
Active
Parent organization
SENIOR CARE WOODBURY, LLC
Other names
Woodbury Villa
Organization subpart
Yes
Provider details
NPI number
Legal business name
SENIOR CARE WOODBURY, LLC
Authorized official
TRICIA MARIE LIES (SR DIRECTOR REVENUE CYCLE)
(612) 286-1170
Entity
Organization
Contact information
Practice address
7008 LAKE ROAD, WOODBURY, MN 55125-3824
(651) 731-5501
Mailing address
7008 LAKE ROAD, WOODBURY, MN 55125-3824
(651) 731-5501
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
115925
HEALTHPARTNERS
MN
01
—
131445
UCARE
MN
01
—
4980442
4980442
MN
05
—
796108100
—
MN
Enumeration date
04/13/2007
Last updated
04/25/2024
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