Organization
GREEN PINE ACRES NURSING HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAURA J AHLF (ADMINISTRATOR)
(218) 564-4101
Entity
Organization
Contact information
Practice address
427 MAIN ST NE, MENAHGA, MN 56464-8702
(218) 564-4101
(218) 564-5309
Mailing address
427 MAIN ST NE, MENAHGA, MN 56464-8702
(218) 564-4101
(218) 564-5309
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
331837
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
475240600
—
MN
01
—
7100487
MEDICA
MN
01
—
7188890
MEDICA
MN
01
—
9530GR
BLUE CROSS BLUE SHIELD
MN
01
—
NH0350
UCARE
MN
Enumeration date
12/14/2006
Last updated
03/02/2022
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