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General NPI Number Information
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NPI Number | 1346014289
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Entity Type | Organization
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Legal Business Name | ELY CAREFREE LIVING
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Dates
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Enumeration Date | 11/10/2023
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 140 S 2ND AVE W
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City | ELY
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State | MN
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Zip | 55731-1167
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Country | US
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Telephone | 218-365-2261
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Fax | 218-365-2214
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Provider Business Mailing Address
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Address Line | 418 9TH ST S
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City | VIRGINIA
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State | MN
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Zip | 55792-2838
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Country | US
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Telephone | 218-741-3013
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Fax | 218-741-1448
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Authorized Official
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Title or Position | SVP OF FINANCE
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Name | JON MONACELLI
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Credential |
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Telephone | 218-741-3013
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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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