Provider Demographics
NPI:1134811102
Name:TWIN RIVERS AFC LLC
Entity type:Organization
Organization Name:TWIN RIVERS AFC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEISA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SCHWAB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-428-6540
Mailing Address - Street 1:1036 SUNSET RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-0645
Mailing Address - Country:US
Mailing Address - Phone:218-428-6540
Mailing Address - Fax:
Practice Address - Street 1:1036 SUNSET RIDGE RD
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-0645
Practice Address - Country:US
Practice Address - Phone:218-428-6540
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home