| NPI | 1396863304 |
|---|---|
| Doing Business As | COUNTRY LANE HOMES |
| Entity Type | Organization |
| Authorized Contact | JACLYN ANNE LANGNER Program Director 320-360-3815 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: MN 1045322-1-AFC) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2008-08-13 |