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General NPI Number Information
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NPI Number | 1871463315
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Entity Type | Organization
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Legal Business Name | HALLOWSTONE WILLMAR OPERATING LLC
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Dates
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Enumeration Date | 11/10/2025
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 1501 19TH AVE SW
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City | WILLMAR
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State | MN
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Zip | 56201-4940
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Country | US
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Telephone | 239-292-1513
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Fax |
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Provider Business Mailing Address
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Address Line | 12811 KENWOOD LN STE 218
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City | FORT MYERS
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State | FL
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Zip | 33907-5645
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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 | COO
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Name | AYLA HARWOOD
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Credential |
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Telephone | 239-292-1513
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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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