Ebenezer Lakes Assisted Living

NPI #1134441827 in Wyoming, Minnesota

Provider Information

NPI Number
1134441827
Entity Type
Organization
Organization Name
Ebenezer Lakes Assisted Living
Primary Specialty
Assisted Living Facility
Enumeration Date
Feb 22, 2010
Last Updated
Feb 22, 2010

Practice Location

Address
25565 FAIRVIEW AVE
ZIP Code
55092-8053
Phone
(651) 982-6228

Authorized Official

Name
MS. KARI BETH WILSON
Title
CAMPUS MANAGER
Phone
(651) 982-6228

Specialties & Taxonomy Codes

Specialty
Assisted Living Facility

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