Provider Demographics
NPI:1598483729
Name:WALKER METHODIST RIVER HEIGHTS, LLC
Entity type:Organization
Organization Name:WALKER METHODIST RIVER HEIGHTS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MARNIE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GUGISBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-763-1164
Mailing Address - Street 1:11055 WAYZATA BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55305-1573
Mailing Address - Country:US
Mailing Address - Phone:612-827-8357
Mailing Address - Fax:612-827-8431
Practice Address - Street 1:744 19TH AVE N
Practice Address - Street 2:
Practice Address - City:SOUTH ST PAUL
Practice Address - State:MN
Practice Address - Zip Code:55075-1360
Practice Address - Country:US
Practice Address - Phone:651-326-6501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-15
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility