| NPI | 1457910713 |
|---|---|
| Doing Business As | EVENTIDE DEVILS LAKE CARE CENTER |
| Entity Type | Organization |
| Authorized Contact | JON RIEWER President & CEO 218-291-2201 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Enumeration Date | 2019-06-11 |
| Last Update Date | 2019-06-11 |