Provider Demographics
NPI:1003576661
Name:MIDWEST CARE FACILITIES LLC
Entity Type:Organization
Organization Name:MIDWEST CARE FACILITIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:MEYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-443-1175
Mailing Address - Street 1:1870 50TH ST E STE 7
Mailing Address - Street 2:
Mailing Address - City:INVER GROVE HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55077-1270
Mailing Address - Country:US
Mailing Address - Phone:651-330-3071
Mailing Address - Fax:651-330-3721
Practice Address - Street 1:2528 PARK AVE NW
Practice Address - Street 2:
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601-2432
Practice Address - Country:US
Practice Address - Phone:218-333-3854
Practice Address - Fax:218-333-3855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-23
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility