Organization
HAWTHORNE HOUSE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSANTHI RENUKA FERNANDO P.H.D (BUSINESS CONSULTANT)
(612) 385-9200
Entity
Organization
Contact information
Practice address
6931 COUNTRY CLUB DR, GOLDEN VALLEY, MN 55427-4604
(612) 385-9200
(763) 205-1950
Mailing address
PO BOX 27482, GOLDEN VALLEY, MN 55427-0482
(612) 385-9200
(763) 205-1950
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
23104
MN
Other
Enumeration date
11/19/2007
Last updated
11/19/2007
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