Healthcare Provider Details

I. General information

NPI: 1326285826
Provider Name (Legal Business Name): PHM NEW RICHMOND SENIOR HOUSINIG INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2009
Last Update Date: 01/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2845 HAMLINE AVE N
SAINT PAUL MN
55113-7127
US

IV. Provider business mailing address

1127 W 8TH ST
NEW RICHMOND WI
54017-1467
US

V. Phone/Fax

Practice location:
  • Phone: 651-631-6000
  • Fax: 651-631-6122
Mailing address:
  • Phone: 715-243-3900
  • Fax: 715-243-3901

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: JOANN WRICH
Title or Position: CAMPUS ADMIN
Credential:
Phone: 715-243-3903