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General NPI Number Information
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NPI Number | 1457356149
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Entity Type | Organization
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Legal Business Name | MADONNA MEADOWS
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Dates
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Enumeration Date | 06/17/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3035 SALEM MEADOWS DR SW
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City | ROCHESTER
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State | MN
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Zip | 55902-2847
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Country | US
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Telephone | 507-252-5400
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Fax | 507-252-5500
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Provider Business Mailing Address
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Address Line | 3035 SALEM MEADOWS DR SW
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City | ROCHESTER
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State | MN
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Zip | 55902-2847
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Country | US
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Telephone | 507-252-5400
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Fax | 507-252-5500
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Authorized Official
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Title or Position | ADMINISTRATOR CEO
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Name | MR. MARK R CAIRNS
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Credential |
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Telephone | 507-288-3911
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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 | 326196
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License Number State | MN
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