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General NPI Number Information
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NPI Number | 1083045124
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Entity Type | Organization
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Legal Business Name | REGINA SENIOR LIVING
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Dates
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Enumeration Date | 11/27/2013
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Last Update Date | 01/22/2026
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Provider Practice Location Address
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Address Line | 1175 NININGER RD
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City | HASTINGS
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State | MN
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Zip | 55033-1056
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Country | US
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Telephone | 651-480-4333
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Fax | 651-404-1286
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Provider Business Mailing Address
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Address Line | 1175 NININGER RD
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City | HASTINGS
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State | MN
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Zip | 55033-1056
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Country | US
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Telephone | 651-480-4333
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Fax | 651-404-1286
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. CHAD KETCHAM
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Credential |
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Telephone | 651-404-1515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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