Healthcare Provider Details

I. General information

NPI: 1023892551
Provider Name (Legal Business Name): BUHL CAREFREE LIVING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2023
Last Update Date: 08/24/2023
Certification Date: 08/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 MONROE DR E
BUHL MN
55713-4438
US

IV. Provider business mailing address

418 9TH ST S
VIRGINIA MN
55792-2838
US

V. Phone/Fax

Practice location:
  • Phone: 218-258-8681
  • Fax: 218-258-8682
Mailing address:
  • Phone: 218-741-3013
  • Fax: 218-741-1448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: JON MONACELLI
Title or Position: SVP OF FINANCE
Credential:
Phone: 218-741-3013