Provider Demographics
NPI:1346346822
Name:WALKER ASSISTED LIVING CORPORATION I
Entity Type:Organization
Organization Name:WALKER ASSISTED LIVING CORPORATION I
Other - Org Name:WALKER METHODIST CARE SUITES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MARNIE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GUGISBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-763-1164
Mailing Address - Street 1:11055 WAYZATA BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55305-1573
Mailing Address - Country:US
Mailing Address - Phone:612-827-5931
Mailing Address - Fax:612-827-8458
Practice Address - Street 1:7400 YORK AVE S
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-5661
Practice Address - Country:US
Practice Address - Phone:952-835-8351
Practice Address - Fax:952-835-7453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN332133310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility