=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750275210
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | OL-US BUHL, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/06/2025
-----------------------------------------------------
Last Update Date | 06/06/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 500 MONROE DR E
-----------------------------------------------------
City | BUHL
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55713-4438
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 218-258-8681
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 500 MONROE DR E
-----------------------------------------------------
City | BUHL
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55713-4438
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | LAWRENCE B, CUMMINGS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 561-371-8577
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 310400000X
-----------------------------------------------------
Taxonomy Name | Assisted Living Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------