NPI 1003563545
Phs-White Bear Lake LLC
Practice location
- Address
- 4650 Centerville Rd, White Bear Lake, MN 55127-3200
- Phone
- (651) 631-6100
- Fax
- (651) 631-6122
- Mailing address
- 2845 Hamline Ave N, Roseville, MN 55113-7127
Authorised official
- Name
- Mark T Meyer
- Title
- Cfo
- Phone
- (651) 631-6102
Registered specialties
Assisted Living Facility
Primary
Registry record
- NPI
- 1003563545
- Entity type
- Organization
- NPI issued
- 4 Mar 2022
- Record last updated
- 11 Nov 2025
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.