Healthcare Provider Details
I. General information
NPI: 1588599286
Provider Name (Legal Business Name): HOUSTON MN OPCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
101 S HILL ST
LA CRESCENT MN
55947-1389
US
IV. Provider business mailing address
456A CENTRAL AVE STE 115
CEDARHURST NY
11516-1907
US
V. Phone/Fax
- Phone: 507-895-4445
- Fax:
- Phone: 646-450-6051
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AARON
KASPER
Title or Position: MANAGER
Credential:
Phone: 646-450-6051