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General NPI Number Information
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NPI Number | 1790789113
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Entity Type | Organization
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Legal Business Name | BARRETT ASSISTED LIVING COMMUNITY, INC.
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Dates
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Enumeration Date | 06/13/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 800 SPRUCE AVE
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City | BARRETT
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State | MN
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Zip | 56311-4505
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Country | US
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Telephone | 320-528-2527
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Fax | 320-528-2642
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Provider Business Mailing Address
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Address Line | 800 SPRUCE AVE
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City | BARRETT
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State | MN
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Zip | 56311-4505
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Country | US
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Telephone | 320-528-2527
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Fax | 320-528-2642
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Authorized Official
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Title or Position | ADMINSITRATOR
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Name | VERNON JUNKER
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Credential |
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Telephone | 320-528-2527
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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 | 3267636
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License Number State | MN
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