Organization
LONG LAKE ASSISTED LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATI GRENGS (DIRECTOR OF OPERATIONS)
(952) 473-2527
Entity
Organization
Contact information
Practice address
345 N BROWN RD, LONG LAKE, MN 55356
(953) 473-2527
(952) 404-9701
Mailing address
345 N BROWN RD, LONG LAKE, MN 55356
(953) 473-2527
(952) 404-9701
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
11/03/2006
Last updated
08/15/2007
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