NPI 1255523858

Martin Lm LLC

Organisation Adult Care Home Facility Bloomington, MN

Practice location

Address: 4616 W 102nd St, Bloomington, MN 55437-2612
Phone: (952) 893-9078
Mailing address: 1401 E 100th St, Bloomington, MN 55425-2615

Authorised official

Name: Denver Kaufman
Title: President
Phone: (612) 371-0053

Registered specialties

Adult Care Home Facility Primary

Nursing & Custodial Care Facilities Taxonomy 311ZA0620X Licence 1045533-1 (MN)

Other Custodial Care Facility providers in Minnesota →

Registry record

NPI: 1255523858
Entity type: Organization
NPI issued: 16 Aug 2007
Record last updated: 17 Dec 2008

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.