Healthcare Provider Details

I. General information

NPI: 1750737276
Provider Name (Legal Business Name): MEEKER MANOR REHABILITATION CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2016
Last Update Date: 05/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 S DAVIS AVE
LITCHFIELD MN
55355-3431
US

IV. Provider business mailing address

638 SOUTHBEND AVE
MANKATO MN
56001-2168
US

V. Phone/Fax

Practice location:
  • Phone: 320-693-2472
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: JOSH LEGUM
Title or Position: MEMEBR
Credential:
Phone: 507-625-8741