Prior Lake Ops LLC
NPI #1003292962 in Prior Lake, Minnesota
Provider Information
- NPI Number
- 1003292962
- Entity Type
- Organization
- Organization Name
- Prior Lake Ops LLC
- Primary Specialty
- Assisted Living Facility
- Enumeration Date
- Aug 3, 2015
- Last Updated
- Aug 3, 2015
Practice Location
- Address
- 4685 PARK NICOLLET AVE SE
- City
- Prior Lake
- State
- Minnesota
- ZIP Code
- 55372-3926
- Phone
- (952) 226-9200
Authorized Official
- Name
- RYAN NOVACZYK
- Title
- PRESIDENT
- Phone
- (952) 241-8204
Specialties & Taxonomy Codes
| Specialty |
|---|
| Assisted Living Facility |
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