Provider Demographics
NPI:1508411257
Name:RM SENIOR LIVING RICHFIELD LLC
Entity Type:Organization
Organization Name:RM SENIOR LIVING RICHFIELD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR, COO
Authorized Official - Prefix:
Authorized Official - First Name:DENYSE
Authorized Official - Middle Name:
Authorized Official - Last Name:ETHRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-243-4585
Mailing Address - Street 1:7645 LYNDALE AVE S STE 110
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55423-6008
Mailing Address - Country:US
Mailing Address - Phone:612-243-4580
Mailing Address - Fax:612-861-2149
Practice Address - Street 1:245 W 76TH ST
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55423-2225
Practice Address - Country:US
Practice Address - Phone:612-286-8762
Practice Address - Fax:612-767-5047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-08
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility