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General NPI Number Information
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NPI Number | 1639734635
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Entity Type | Organization
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Legal Business Name | BENEDICTINE LIVING COMMUNITY OF NORTHFIELD, LLC
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Dates
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Enumeration Date | 05/06/2019
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Last Update Date | 01/22/2026
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Provider Practice Location Address
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Address Line | 2030 NORTH AVENUE
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City | NORTHFIELD
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State | MN
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Zip | 55057
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Country | US
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Telephone | 612-991-6519
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Fax |
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Provider Business Mailing Address
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Address Line | 2030 NORTH AVE
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City | NORTHFIELD
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State | MN
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Zip | 55057-1587
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Country | US
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Telephone | 507-512-5720
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Fax |
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Authorized Official
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Title or Position | VP OF HCBS
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Name | PENNIE VIGGIANO
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Credential |
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Telephone | 651-529-8788
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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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