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General NPI Number Information
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NPI Number | 1629401138
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Entity Type | Organization
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Legal Business Name | VILLA AT OSSEO LLC
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Dates
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Enumeration Date | 08/20/2013
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Last Update Date | 08/20/2013
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Provider Practice Location Address
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Address Line | 501 2ND ST SE
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City | OSSEO
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State | MN
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Zip | 55369-1603
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Country | US
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Telephone | 763-425-3939
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Fax | 763-424-2777
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Provider Business Mailing Address
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Address Line | 501 2ND ST SE
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City | OSSEO
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State | MN
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Zip | 55369-1603
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Country | US
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Telephone | 763-425-3939
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Fax | 763-424-2777
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Authorized Official
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Title or Position | ATTORNEY
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Name | MS. FRANCES MEEHAN
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Credential | ESQ.
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Telephone | 312-521-2467
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number |
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License Number State |
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