Provider Demographics
NPI:1326602780
Name:PILLARS OF MANKATO LLC
Entity Type:Organization
Organization Name:PILLARS OF MANKATO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STACY
Authorized Official - Middle Name:
Authorized Official - Last Name:WIHLM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-344-6777
Mailing Address - Street 1:3125 PRAIRIE ROSE DR
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-2618
Mailing Address - Country:US
Mailing Address - Phone:507-344-6777
Mailing Address - Fax:
Practice Address - Street 1:3125 PRAIRIE ROSE DR
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-2618
Practice Address - Country:US
Practice Address - Phone:507-344-6777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-30
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility