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General NPI Number Information
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NPI Number | 1760618607
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Entity Type | Organization
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Legal Business Name | METROPOLITAN LIVING, LLC
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Dates
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Enumeration Date | 06/05/2009
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Last Update Date | 10/19/2010
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Provider Practice Location Address
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Address Line | 9230 5TH AVE S
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City | BLOOMINGTON
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State | MN
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Zip | 55420-3812
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Country | US
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Telephone | 952-888-1194
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Fax | 952-888-1194
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Provider Business Mailing Address
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Address Line | 2105 W BURNSVILLE PKWY
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City | BURNSVILLE
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State | MN
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Zip | 55337-4237
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Country | US
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Telephone | 952-564-3006
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Fax | 952-746-7897
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. BRIAN P SAMMON
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Credential | LMFT, LADC
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Telephone | 612-226-7120
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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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