Provider Demographics
NPI:1427056498
Name:ARROWHEAD SENIOR LIVING COMMUNITY
Entity type:Organization
Organization Name:ARROWHEAD SENIOR LIVING COMMUNITY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:A
Authorized Official - Last Name:HIGH
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:218-748-7801
Mailing Address - Street 1:1201 8TH ST S
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA
Mailing Address - State:MN
Mailing Address - Zip Code:55792-3349
Mailing Address - Country:US
Mailing Address - Phone:218-748-7800
Mailing Address - Fax:218-748-7890
Practice Address - Street 1:1201 8TH ST S
Practice Address - Street 2:
Practice Address - City:VIRGINIA
Practice Address - State:MN
Practice Address - Zip Code:55792-3349
Practice Address - Country:US
Practice Address - Phone:218-748-7800
Practice Address - Fax:218-748-7890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN327281314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN5102971OtherSTATE EIN
24-5283Medicare ID - Type Unspecified