Organization Name: | FIVE STAR LIVING OF BRAINERD, LLC |
NPI Number: | 1093842247 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LYNN GEVIK (COO) |
Mailing Address: | 14396 Grand Oaks Dr Baxter |
State: | MN US |
Postal Code: | 56425 |
Phone Number: | 2186252316 |
Fax Number: | 2187279559 |
NPI Enumeration Date: | 02/27/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 310400000X |
License Number: | 332934 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Nursing & Custodial Care Facilities |
Taxonomy Classification: | Assisted Living Facility |
Taxonomy Specialization: | |
Taxonomy Definition: | A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |