Organization
PARK PLACE SENIOR LIVING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVE VANDERGON (CEO/ADMINISTRATOR)
(612) 961-9672
Entity
Organization
Contact information
Practice address
125 E PARK ST, OWATONNA, MN 55060-4067
(507) 451-0808
Mailing address
1995 E RUM RIVER DR S, CAMBRIDGE, MN 55008-2656
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
11/09/2017
Last updated
11/09/2017
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