Ridgewood Manor
Custodial Care Facility, Adult Care Home in Elk River, MN. Organization (NPI-2).
NPI number1407280720
StatusActive
Last updated in NPPESAug 22, 2013
Details
- NPI
- 1407280720
- Entity type
- Organization (NPI-2)
- Legal business name
- Ridgewood Manor
- Organization subpart
- No
- Enumeration date
- Aug 22, 2013
- Last updated
- Aug 22, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 311ZA0620X | Custodial Care Facility, Adult Care Home | 1066808-1-AFC | MN | Yes |
Practice location
10038 215th Ave NwElk River, MN 55330-8519
Phone 763-607-6874 · Fax 267-350-9164
Mailing address
10038 215th Ave NwElk River, MN 55330-8519
Phone 763-607-6874 · Fax 267-350-9164
Authorized official
Gregory M Petersen
Partner
7636076874
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