Provider Demographics
NPI:1710195649
Name:MARION SENIOR DEVELOPMENT LLC
Entity Type:Organization
Organization Name:MARION SENIOR DEVELOPMENT LLC
Other - Org Name:SUMMIT POINTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAUGEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-455-4015
Mailing Address - Street 1:3737 BRYANT AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55409-1019
Mailing Address - Country:US
Mailing Address - Phone:612-827-5931
Mailing Address - Fax:612-827-8458
Practice Address - Street 1:3505 ENGLISH GLEN CT
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IA
Practice Address - Zip Code:52302
Practice Address - Country:US
Practice Address - Phone:319-373-4242
Practice Address - Fax:319-373-3013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAS0248310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAS0248OtherASSISTED LIVING LICENSE