Phs-White Bear Lake LLC
NPI #1003563545 in White Bear Lake, Minnesota
Provider Information
- NPI Number
- 1003563545
- Entity Type
- Organization
- Organization Name
- Phs-White Bear Lake LLC
- Primary Specialty
- Assisted Living Facility
- Enumeration Date
- Mar 4, 2022
- Last Updated
- Nov 11, 2025
Practice Location
- Address
- 4650 CENTERVILLE RD
- City
- White Bear Lake
- State
- Minnesota
- ZIP Code
- 55127-3200
- Phone
- (651) 631-6100
Authorized Official
- Name
- MARK T MEYER
- Title
- CFO
- Phone
- (651) 631-6102
Specialties & Taxonomy Codes
| Specialty |
|---|
| Assisted Living Facility |
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