MEDICARE: MARGARET PLACE LIMITED PARTNERSHIP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility	350522	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710262399
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARGARET PLACE LIMITED PARTNERSHIP

Provider Business Mailing Address
First Line	:	1555 118TH LN NW
Second Line	:
City	:	COON RAPIDS
State	:	MN
Zip	:	55448-7579
Country	:	US
Telephone Number	:	763-754-2505
Fax Number	:

Provider Business Practice Location Address
First Line	:	1555 118TH LN NW
Second Line	:
City	:	COON RAPIDS
State	:	MN
Zip	:	55448-7579
Country	:	US
Telephone Number	:	763-754-2505
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF HOUSING WITH SERVICES
Name	:	RUTH DAHL
Credential	:
Telephone Number	:	763-862-5484

Provider Enumeration Date	:	10/14/2011
Last Update Date	:	10/14/2011

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