Organization
CORNERSTONE RESIDENCE OF BAGLEY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALLEN POTVIN (OWNER/PRESIDENT)
(218) 435-6205
Entity
Organization
Contact information
Practice address
30 SUNSET AVE SW, BAGLEY, MN 56621
(218) 694-2701
(218) 694-2718
Mailing address
30 SUNSET AVE SW, BAGLEY, MN 56621
(218) 694-2701
(218) 694-2718
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
MN
Other
Enumeration date
06/04/2009
Last updated
06/04/2009
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