Autumn Woods Iii, LLC

NPI #1497249320 in Anoka, Minnesota

Provider Information

NPI Number
1497249320
Entity Type
Organization
Organization Name
Autumn Woods Iii, LLC
Subpart
Yes (part of a larger organization)
Parent Organization
AUTUMN WOODS III, LLC
Primary Specialty
Assisted Living Facility
Enumeration Date
Jun 14, 2018
Last Updated
Jun 14, 2018

Practice Location

Address
910 WESTERN ST
City
Anoka
ZIP Code
55303-2002
Phone
(763) 421-4011

Authorized Official

Name
LESLIE RICHARD LEITH, DO
Title
CONTROLLER
Phone
(952) 920-0400

Specialties & Taxonomy Codes

Specialty
Assisted Living Facility

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