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General NPI Number Information
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NPI Number | 1649970484
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Entity Type | Organization
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Legal Business Name | SHEPHERDS INN ASSISTED LIVING INC
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Dates
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Enumeration Date | 03/09/2023
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Last Update Date | 03/09/2023
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Provider Practice Location Address
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Address Line | 46 1ST AVE SW
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City | WELLS
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State | MN
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Zip | 56097-1932
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Country | US
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Telephone | 507-553-6217
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Fax | 507-553-6830
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Provider Business Mailing Address
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Address Line | 64667 150TH ST
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City | ALDEN
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State | MN
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Zip | 56009-5550
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Country | US
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Telephone | 701-388-2888
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Fax | 507-299-9911
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Authorized Official
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Title or Position | PRESIDENT
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Name | CAROL LYNN SCHROEDER
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Credential |
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Telephone | 701-388-2888
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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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