Provider Demographics
NPI:1649727231
Name:OAK TERRACE SENIOR HOUSING OF LE SUEUR
Entity type:Organization
Organization Name:OAK TERRACE SENIOR HOUSING OF LE SUEUR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DREW
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:HOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-387-2037
Mailing Address - Street 1:811 S. 4TH ST.
Mailing Address - Street 2:
Mailing Address - City:LE SUEUR
Mailing Address - State:MN
Mailing Address - Zip Code:56058-2203
Mailing Address - Country:US
Mailing Address - Phone:507-593-8500
Mailing Address - Fax:507-665-4303
Practice Address - Street 1:811 S. 4TH ST.
Practice Address - Street 2:
Practice Address - City:LE SUEUR
Practice Address - State:MN
Practice Address - Zip Code:56058-2203
Practice Address - Country:US
Practice Address - Phone:507-593-8500
Practice Address - Fax:507-665-4303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility