Organization
FIVE STAR LIVING LLC
Active
Other names
DIAMOND WILLOW
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LYMM GEVIK RN (COO)
(218) 625-2316
Entity
Organization
Contact information
Practice address
1558 RANDOLPH RD, DETROIT LAKES, MN 56501-3745
(218) 625-2316
(218) 625-2338
Mailing address
11 E SUPERIOR ST, SUITE 230, DULUTH, MN 55802-2007
(218) 625-2316
(218) 625-2338
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
336184
MN
Other
Enumeration date
10/02/2007
Last updated
10/02/2007
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