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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MEDICINE LAKE MANOR

Active Organization

MEDICINE LAKE MANOR is a Assisted Living Facility organization located in PLYMOUTH, Minnesota. NPI 1104221605 is currently active in the NPPES registry. Verify at CMS.

Assisted Living Facility · PLYMOUTH, MN

Registration Details

NPI Number
1104221605
Provider Type
Organization
NPI Issued
Oct 27, 2014 (11.816363362631 yrs)
Last Updated
Oct 27, 2014
License
370431 (MN)

Practice Information

Address
10230 28TH AVE N
PLYMOUTH, MN, 55441
Browse MN providers · Browse ZIP 55441
Phone
7635464017
Primary Specialty
Assisted Living Facility
310400000X
Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.