Provider Demographics
NPI:1306185681
Name:NEW JOURNEY RESIDENCE, LTD
Entity Type:Organization
Organization Name:NEW JOURNEY RESIDENCE, LTD
Other - Org Name:WHISPERING PINES ASSISTED LIVING AND MEMORY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-326-6900
Mailing Address - Street 1:20371 WENDIGO PARK RD
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55744-4675
Mailing Address - Country:US
Mailing Address - Phone:218-326-6900
Mailing Address - Fax:
Practice Address - Street 1:20371 WENDIGO PARK RD
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55744-4675
Practice Address - Country:US
Practice Address - Phone:218-326-6900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-07
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility