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Active
Organization subpart
No

Provider details

NPI number
Authorized official
KATIE L KENDALL LNHA (ADMINISTRATOR)
(507) 962-3275
Entity
Organization

Contact information

Practice address
505 E 4TH ST, HILLS, MN 56138-1017
(507) 962-3275
(507) 962-3277
Mailing address
505 E 4TH ST, HILLS, MN 56138-1017
(507) 962-3275
(507) 962-3277

Taxonomy

Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
328220
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
230743000
MN
01
9504TU
BLUE CROSS/BLUE SHIELD #
MN
Enumeration date
07/28/2005
Last updated
07/21/2025
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