Provider Demographics
NPI:1154500833
Name:FALLS LANDING ASSISTED LIVING
Entity Type:Organization
Organization Name:FALLS LANDING ASSISTED LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-562-6648
Mailing Address - Street 1:1101 N HIAWATHA AVE
Mailing Address - Street 2:
Mailing Address - City:PIPESTONE
Mailing Address - State:MN
Mailing Address - Zip Code:56164-2308
Mailing Address - Country:US
Mailing Address - Phone:507-562-6648
Mailing Address - Fax:507-562-6648
Practice Address - Street 1:1101 N HIAWATHA AVE
Practice Address - Street 2:
Practice Address - City:PIPESTONE
Practice Address - State:MN
Practice Address - Zip Code:56164-2308
Practice Address - Country:US
Practice Address - Phone:507-562-6648
Practice Address - Fax:507-562-6648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-30
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN334289310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility