Provider Demographics
NPI:1467745273
Name:COKATO CHARITABLE TRUST
Entity Type:Organization
Organization Name:COKATO CHARITABLE TRUST
Other - Org Name:EDGEWOOD GABLES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:R
Authorized Official - Last Name:STRATMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-286-3103
Mailing Address - Street 1:600 3RD ST SE
Mailing Address - Street 2:
Mailing Address - City:COKATO
Mailing Address - State:MN
Mailing Address - Zip Code:55321-9402
Mailing Address - Country:US
Mailing Address - Phone:320-286-2159
Mailing Address - Fax:320-286-5729
Practice Address - Street 1:600 3RD ST SE
Practice Address - Street 2:
Practice Address - City:COKATO
Practice Address - State:MN
Practice Address - Zip Code:55321-9402
Practice Address - Country:US
Practice Address - Phone:320-286-2159
Practice Address - Fax:320-286-5729
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COKATO CHARITABLE TRUST
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-05-26
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNHFID20523310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility