Healthcare Provider Details

I. General information

NPI: 1588458244
Provider Name (Legal Business Name): BTW RESIDENCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2025
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2532 59TH ST NW
ROCHESTER MN
55901-8745
US

IV. Provider business mailing address

2532 59TH ST NW
ROCHESTER MN
55901-8745
US

V. Phone/Fax

Practice location:
  • Phone: 507-358-5276
  • Fax:
Mailing address:
  • Phone: 507-358-5276
  • 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: AHMEDNUR ALI
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 507-358-5276