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General NPI Number Information
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NPI Number | 1841409836
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Entity Type | Organization
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Legal Business Name | WILLIAMS, INC.
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2500 PILLSBURY AVE S
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City | MINNEAPOLIS
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State | MN
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Zip | 55404-4201
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Country | US
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Telephone | 612-872-8363
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Fax |
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Provider Business Mailing Address
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Address Line | 12004 COUNTY ROAD 11
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City | BURNSVILLE
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State | MN
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Zip | 55337-3016
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Country | US
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Telephone | 952-808-0413
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Fax |
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Authorized Official
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Title or Position | BILLER
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Name | MARIA ROG
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Credential |
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Telephone | 952-808-0413
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 00173
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License Number State | MN
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