Saint Therese Of Oxbow Lake, LLC
Skilled Nursing Facility in Brooklyn Park, MN. Organization (NPI-2).
NPI number1619236767
StatusActive
Last updated in NPPESNov 22, 2021
Details
- NPI
- 1619236767
- Entity type
- Organization (NPI-2)
- Legal business name
- Saint Therese Of Oxbow Lake, LLC
- Organization subpart
- No
- Enumeration date
- May 10, 2012
- Certification date
- Nov 22, 2021
- Last updated
- Nov 22, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 314000000X | Skilled Nursing Facility | – | – | Yes |
Practice location
9751 Regent Ave. No.Brooklyn Park, MN 55443
Phone 763-493-7007
Mailing address
9751 Regent Ave. No.Brooklyn Park, MN 55443
Phone 763-493-7007
Authorized official
Cal M Shelangoski
Cfo
9522832204
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