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General NPI Number Information
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NPI Number | 1326042151
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Entity Type | Organization
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Legal Business Name | GOLDEN OAKS INC.
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Dates
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Enumeration Date | 06/09/2005
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Last Update Date | 08/20/2008
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Provider Practice Location Address
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Address Line | 4067 RUNKE RD
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City | HERMANTOWN
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State | MN
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Zip | 55811
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Country | US
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Telephone | 218-729-5014
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Fax | 218-729-0319
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Provider Business Mailing Address
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Address Line | 4067 RUNKE RD
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City | HERMANTOWN
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State | MN
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Zip | 55811
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Country | US
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Telephone | 218-729-5014
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Fax | 218-729-0319
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Authorized Official
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Title or Position | DIRECTOR OF NURSING/OWNER
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Name | MRS. LAURA MARIE LOKKEN
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Credential |
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Telephone | 218-729-5014
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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 | 327279
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License Number State | MN
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