Organization · Type 2 NPI

Medicine Lake Manor

Assisted Living Facility · Plymouth, MN

NPI number 1104221605 Active

Practice location

10230 28th Ave N
Plymouth, MN 55441

Call (763) 546-4017 Map

Specialties and licenses

TaxonomyCodeLicense
Assisted Living Facility Primary 310400000X370431 (MN)

Assisted Living Facility: A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

2 other providers at this address

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About NPI 1104221605

Medicine Lake Manor's National Provider Identifier is 1104221605, issued on Oct 27, 2014. The primary taxonomy on file is Assisted Living Facility (310400000X), and the practice location is in Plymouth, MN. The record was last updated on Oct 27, 2014.