Provider Demographics
NPI:1114023686
Name:WALKER SENIOR HOUSING CORPORATION III
Entity Type:Organization
Organization Name:WALKER SENIOR HOUSING CORPORATION III
Other - Org Name:WALKER PLAZA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:BLAHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-827-8380
Mailing Address - Street 1:3737 BRYANT AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55409-1019
Mailing Address - Country:US
Mailing Address - Phone:612-827-5931
Mailing Address - Fax:612-827-8458
Practice Address - Street 1:131 MONROE ST
Practice Address - Street 2:
Practice Address - City:ANOKA
Practice Address - State:MN
Practice Address - Zip Code:55303-2484
Practice Address - Country:US
Practice Address - Phone:763-422-4037
Practice Address - Fax:763-422-8115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN332179310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility