Healthcare Provider Details

I. General information

NPI: 1346645538
Provider Name (Legal Business Name): ALLINA HEALTH RESTORATIVE SUITES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2014
Last Update Date: 06/07/2023
Certification Date: 06/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2775 CAMPUS DRIVE NORTH
PLYMOUTH MN
55441
US

IV. Provider business mailing address

2925 CHICAGO AVE
MINNEAPOLIS MN
55407-1321
US

V. Phone/Fax

Practice location:
  • Phone: 651-631-6100
  • Fax:
Mailing address:
  • Phone: 612-262-9000
  • 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: EMILY RUTH CONOVER DOWNING
Title or Position: CEO
Credential:
Phone: 612-262-7800