Provider Demographics
NPI:1407680473
Name:PRESBYTERIAN HOMES BLOOMINGTON CARE CENTER, INC
Entity type:Organization
Organization Name:PRESBYTERIAN HOMES BLOOMINGTON CARE CENTER, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:T
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-631-6120
Mailing Address - Street 1:2845 HAMLINE AVE N
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55113-7127
Mailing Address - Country:US
Mailing Address - Phone:651-631-6102
Mailing Address - Fax:
Practice Address - Street 1:9889 PENN AVE S
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55431-2912
Practice Address - Country:US
Practice Address - Phone:952-942-2676
Practice Address - Fax:952-948-3081
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRESBYTERIAN HOMES BLOOMINGTON CARE CENTER, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-08-30
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility