| NPI | 1043210925 |
|---|---|
| Doing Business As | FAIR OAKS LODGE |
| Entity Type | Organization |
| Authorized Contact | ERIC R. LUNDE President 218-631-1163 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: MN 357827) |
| Additional Taxonomies | 251E00000X Home Health (Licence: MN 358367) |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2013-06-25 |