Organization
METROPOLITAN LIVING, LLC
Active
Other names
Matilde House
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN P SAMMON LMFT, LADC (PRESIDENT)
(612) 226-7120
Entity
Organization
Contact information
Practice address
9230 5TH AVE S, BLOOMINGTON, MN 55420-3812
(952) 888-1194
(952) 888-1194
Mailing address
2105 W BURNSVILLE PKWY, BURNSVILLE, MN 55337-4237
(952) 564-3006
(952) 746-7897
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
162386
UCARE
MN
01
—
26106
MN DEPARTMENT OF HEALTH REGISTRATION
MN
01
—
348244
HOUSING WITH SERVICES
MN
01
—
348730
CLASS F HOME CARE PROVIDER
MN
Enumeration date
06/05/2009
Last updated
10/19/2010
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