Organization
NORTHSIDE LIFE CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CINDY LORSUNG (EXECUTIVE DIRECTOR)
(612) 522-6589
Entity
Organization
Contact information
Practice address
4367 THOMAS AVE N, MINNEAPOLIS, MN 55412-1005
(912) 522-6589
Mailing address
4367 THOMAS AVE N, MINNEAPOLIS, MN 55412-1005
(912) 522-6589
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
—
—
Other
Enumeration date
08/06/2009
Last updated
08/06/2009
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