Provider Demographics
NPI:1487802450
Name:GUIDED TRANSITIONS LLC
Entity type:Organization
Organization Name:GUIDED TRANSITIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:F
Authorized Official - Last Name:WICKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-249-1144
Mailing Address - Street 1:PO BOX 236
Mailing Address - Street 2:
Mailing Address - City:COTTON
Mailing Address - State:MN
Mailing Address - Zip Code:55724-0236
Mailing Address - Country:US
Mailing Address - Phone:218-249-1144
Mailing Address - Fax:218-461-1999
Practice Address - Street 1:905 N BASSWOOD AVE
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55811-5100
Practice Address - Country:US
Practice Address - Phone:218-249-1144
Practice Address - Fax:218-461-1999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-03
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1052308311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home