Fmg West 36 1/2 Street Minnesota LLC
NPI #1861884199 in St Louis Park, Minnesota
Provider Information
- NPI Number
- 1861884199
- Entity Type
- Organization
- Organization Name
- Fmg West 36 1/2 Street Minnesota LLC
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Feb 24, 2015
- Last Updated
- Feb 24, 2015
Practice Location
- Address
- 4415 W 36 1/2 ST
- City
- St Louis Park
- State
- Minnesota
- ZIP Code
- 55416-4854
- Phone
- (952) 927-9717
Authorized Official
- Name
- DAVID KEATING
- Title
- AUTHORIZED OFFICIAL
- Phone
- (414) 908-8058
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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