Provider Demographics
NPI:1073633202
Name:TERRACE HEIGHTS ASSISTED LIVING APARTMENTS
Entity Type:Organization
Organization Name:TERRACE HEIGHTS ASSISTED LIVING APARTMENTS
Other - Org Name:GALEON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WALTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-859-4600
Mailing Address - Street 1:410 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:OSAKIS
Mailing Address - State:MN
Mailing Address - Zip Code:56360-8243
Mailing Address - Country:US
Mailing Address - Phone:320-859-2142
Mailing Address - Fax:320-859-6292
Practice Address - Street 1:410 W MAIN ST
Practice Address - Street 2:
Practice Address - City:OSAKIS
Practice Address - State:MN
Practice Address - Zip Code:56360-8243
Practice Address - Country:US
Practice Address - Phone:320-859-4600
Practice Address - Fax:320-859-6292
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMMUNITY MEMORIAL HOME AT OSAKIS MINNESOTA INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-30
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN03092000501OtherPRIME WEST