Legacy of Brownsdale, LLC
Organization Active NPI Assisted Living Facility · Brownsdale, MN
NPI 1477038966 · NPPES record last updated Jul 15, 2023
Key facts
- NPI
- 1477038966
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Assisted Living Facility 310400000X
- Legal business name
- LEGACY OF BROWNSDALE, LLC
- Practice address
- 105 Latham St NE
Brownsdale, MN 55918 - Phone
- (507) 460-0235
- NPI assigned
- Oct 1, 2018
- Organization subpart
- No
Authorized official
- Name
- Ms. Deidra Sue Burke
- Title
- Ceo
- Phone
- (507) 203-1818
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 24D2161731 | Legacy of Brownsdale | Certificate of waiver | Feb 7, 2027 |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | Yes |
Addresses
Primary practice location
105 Latham St NE
Brownsdale, MN 55918
Mailing address
105 Latham St NE
Brownsdale, MN 55918
Phone (507) 203-1818
Other providers in Brownsdale, MN
All providers in Brownsdale, MN · Assisted Living Facility in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 15, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.