Doctor Name: | CYNTHIA LOUISE STORY |
NPI Number: | 1215221577 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 353080 |
Business Practice Address: | 401 South Ave Two Harbors, MN - 556161648 |
Business Phone Number: | 2188348018 |
Business Fax Number: | 2188348019 |
Mailing Address: | 401 South Ave, TWO HARBORS |
State: | MN |
Postal Code: | 556161648 |
Phone Number: | 2188348018 |
Fax Number: | 2188348019 |
NPI Enumeration Date: | 06/04/2011 |
NPI Last Update Date: | 06/04/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 310400000X |
License Number: | 353080 |
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. |