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General NPI Number Information
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NPI Number | 1770403974
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Entity Type | Organization
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Legal Business Name | MEADOW RIDGE GARDENS LLC
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Dates
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Enumeration Date | 07/17/2026
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Last Update Date | 07/17/2026
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Provider Practice Location Address
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Address Line | 7475 COUNTRY CLUB DR
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City | GOLDEN VALLEY
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State | MN
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Zip | 55427-4622
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Country | US
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Telephone | 651-706-3591
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Fax |
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Provider Business Mailing Address
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Address Line | 1805 NW PLATTE RD STE 100
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City | RIVERSIDE
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State | MO
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Zip | 64150-7500
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEDICARE AUTHORIZED OFFICIAL
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Name | CHAIM MANDELBAUM
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Credential |
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Telephone | 816-429-0850
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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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