Healthcare Provider Details

I. General information

NPI: 1700727260
Provider Name (Legal Business Name): EDINA AL OPERATIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2026
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3450 HERITAGE DR
EDINA MN
55435-2263
US

IV. Provider business mailing address

3456 HERITAGE DR
EDINA MN
55435-2204
US

V. Phone/Fax

Practice location:
  • Phone: 773-825-3336
  • Fax:
Mailing address:
  • Phone: 773-825-3336
  • Fax:

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: MAX STESEL
Title or Position: MANAGER
Credential:
Phone: 773-825-3336