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General NPI Number Information
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NPI Number | 1881541555
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Entity Type | Organization
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Legal Business Name | MINNETONKA WBLVD MC OWNER, LLC
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Dates
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Enumeration Date | 03/12/2026
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Last Update Date | 03/12/2026
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Provider Practice Location Address
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Address Line | 1520 CLARE LANE
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City | MINNETONKA
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State | MN
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Zip | 55391
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Country | US
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Telephone | 952-295-8200
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Fax |
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Provider Business Mailing Address
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Address Line | 1520 CLARE LANE
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City | MINNETONKA
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State | MN
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Zip | 55391
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Country | US
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Telephone | 952-295-8200
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Fax |
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Authorized Official
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Title or Position | REGIONAL AL DIRECTOR
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Name | STACY FEMLING
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Credential |
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Telephone | 507-269-0519
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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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