Provider Demographics
NPI:1932969326
Name:ZURIEL ASSISTED LIVING LLC
Entity Type:Organization
Organization Name:ZURIEL ASSISTED LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:FOSTER
Authorized Official - Middle Name:R
Authorized Official - Last Name:KILLEN
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:763-400-6731
Mailing Address - Street 1:5506 IRVING AVE N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55430-3073
Mailing Address - Country:US
Mailing Address - Phone:763-400-6731
Mailing Address - Fax:
Practice Address - Street 1:5506 IRVING AVENUE NORTH,
Practice Address - Street 2:
Practice Address - City:BROOKLYN CENTER
Practice Address - State:MN
Practice Address - Zip Code:55430
Practice Address - Country:US
Practice Address - Phone:763-400-6731
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-21
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174200000XOther Service ProvidersMeals