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Organization

FCSL BAXTER, LLC

Active
Other names
DIAMOND WILLOW ASSISTED LIVING
Organization subpart
No

Provider details

NPI number
Authorized official
NATALIE ZELEZNIKAR (OWNER)
(218) 625-8488
Entity
Organization

Contact information

Practice address
14396 GRAND OAKS DR, BAXTER, MN 56425-8747
(218) 825-7034
Mailing address
2701 W SUPERIOR ST, SUITE 101, DULUTH, MN 55806-1856
(218) 625-8488
(218) 625-2338

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
370708
MN

Other

Enumeration date
12/02/2014
Last updated
12/02/2014
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