SHERBURN ECONOMIC DEVELOPMENT AUTHORITY
Assisted Living Facility
Sherburn, Minnesota
Provider NPI: 1285690347
Organization Information:Organization Name: SHERBURN ECONOMIC DEVELOPMENT AUTHORITY
Practice Location:
410 FOX LAKE AVE SHERBURN, MN 56171 US
Tel: 952-888-2923 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
410 FOX LAKE AVE SHERBURN, MN 56171 US
Tel: 952-888-2923 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 310400000X | Nursing & Custodial Care Facilities Assisted Living Facility | MN | 329269 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
250473100 | MN | 05 | |
HWS | 329269 | MN | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin