Organization
CRESCENT COVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHRYN J. LINDENFELSER MT-BC (EXEC. DIRECTOR)
(952) 426-4711
Entity
Organization
Contact information
Practice address
4201 58TH AVD N., BROOKLYN CENTER, MN 55429
(952) 426-4711
Mailing address
3440 BELTLINE BLVD. STE 207, ST. LOUIS PARK, MN 55416
(952) 426-4711
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
251G00000X
Community Based Hospice Care Agency
Primary
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A101662400
UMPI
MN
Enumeration date
12/21/2018
Last updated
01/09/2019
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