| NPI | 1124234554 |
|---|---|
| Other Name | COUNTRYSIDE CATERED SENIOR LIVING |
| Entity Type | Organization |
| Authorized Contact | LORETTA M LEWIS Sr. Credentialing Specialist 651-766-4375 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: MN 334372) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2024-04-24 |