Individual
MS. JULIE A BONGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17810 AMES CT, FARIBAULT, MN 55021-7933
(507) 838-5991
(507) 838-5991
Mailing address
17810 AMES COURT, FARIBAULT, MN 55021
(507) 838-5991
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
272601
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
272601
MN ADULT FOSTER CARE LICENSE NUMBER
MN
Enumeration date
08/31/2017
Last updated
08/31/2017
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