Provider Demographics
NPI:1467818690
Name:ROSEMOUNT SENIOR LIVING OPERATIONS, LLC
Entity Type:Organization
Organization Name:ROSEMOUNT SENIOR LIVING OPERATIONS, LLC
Other - Org Name:THE ROSEMOUNT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:KITTELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-238-5205
Mailing Address - Street 1:14344 CAMEO AVE W
Mailing Address - Street 2:
Mailing Address - City:ROSEMOUNT
Mailing Address - State:MN
Mailing Address - Zip Code:55068-4066
Mailing Address - Country:US
Mailing Address - Phone:651-322-4222
Mailing Address - Fax:
Practice Address - Street 1:14344 CAMEO AVE W
Practice Address - Street 2:
Practice Address - City:ROSEMOUNT
Practice Address - State:MN
Practice Address - Zip Code:55068-4066
Practice Address - Country:US
Practice Address - Phone:651-322-4222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-04
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility