Provider Demographics
NPI:1659725364
Name:WARREN ECONOMIC DEVELOPMENT AUTHORITY
Entity Type:Organization
Organization Name:WARREN ECONOMIC DEVELOPMENT AUTHORITY
Other - Org Name:NORTH STAR ASSISTED LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MORGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SKEIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-745-5282
Mailing Address - Street 1:410 S. MCKINLEY STREET
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MN
Mailing Address - Zip Code:56762-1433
Mailing Address - Country:US
Mailing Address - Phone:218-745-5282
Mailing Address - Fax:218-745-6434
Practice Address - Street 1:400 S MCKINLEY ST
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MN
Practice Address - Zip Code:56762-1439
Practice Address - Country:US
Practice Address - Phone:218-745-4125
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-19
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility