Organization Name: | WATERFORD MANOR OPERATIONS LLC |
NPI Number: | 1356686836 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JUDI L BUXO (SR VP-DIR OF ASSET MANAGEMENT) |
Mailing Address: | 6288 Louisiana Ct N Brooklyn Park |
State: | MN US |
Postal Code: | 554282550 |
Phone Number: | 7635537338 |
Fax Number: | 7635352075 |
NPI Enumeration Date: | 12/10/2012 |
NPI Last Update Date: | 12/10/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 310400000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
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. |