Fmg Portland Avenue South Minnesota LLC
NPI #1063801868 in Richfield, Minnesota
Provider Information
- NPI Number
- 1063801868
- Entity Type
- Organization
- Organization Name
- Fmg Portland Avenue South Minnesota LLC
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Jan 16, 2015
- Last Updated
- Jan 16, 2015
Practice Location
Authorized Official
- Name
- DAVID KEATING
- Title
- AUTHORIZED OFFICIAL
- Phone
- (414) 908-8058
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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