Bethany Board And Lodge, INC
Assisted Living Facility in McIntosh, MN. Organization (NPI-2).
NPI number1669942298
StatusActive
Last updated in NPPESNov 27, 2018
Details
- NPI
- 1669942298
- Entity type
- Organization (NPI-2)
- Legal business name
- Bethany Board And Lodge, INC
- Organization subpart
- No
- Enumeration date
- Nov 27, 2018
- Last updated
- Nov 27, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 310400000X | Assisted Living Facility | – | – | Yes |
Other names
- Riverside Customized Living (Doing Business As)
Practice location
240 1st St NeMcIntosh, MN 56556
Phone 218-435-1044 · Fax 218-435-1143
Mailing address
Po Box 28Fosston, MN 56542
Phone 218-435-1044 · Fax 218-435-1143
Authorized official
Tyler McGlynn
President
2182801609
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Checking a whole list?
Paste up to 5,000 NPIs and download status, name, taxonomy, license and address for each one. Useful for credentialing, billing and pharmacy claim checks.