Healthcare Provider Details

I. General information

NPI: 1013959998
Provider Name (Legal Business Name): LIFE CARE RETIREMENT COMMUNITIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8100 HIGHWOOD DR
BLOOMINGTON MN
55438-1079
US

IV. Provider business mailing address

8100 HIGHWOOD DR
BLOOMINGTON MN
55438-1079
US

V. Phone/Fax

Practice location:
  • Phone: 952-831-7500
  • Fax: 952-830-9893
Mailing address:
  • Phone: 952-831-7500
  • Fax: 952-830-9893

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311Z00000X
TaxonomyCustodial Care Facility
License Number331198
License Number StateMN

VIII. Authorized Official

Name: RICHARD MEYER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 952-830-9590