Legacy Senior Services
Organization Active NPI Skilled Nursing Facility · Wheaton, MN
NPI 1558366146 · NPPES record last updated Apr 9, 2020
Key facts
- NPI
- 1558366146
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 00669 (MN)
- Legal business name
- LEGACY SENIOR SERVICES
- Practice address
- 303 7TH St S
Wheaton, MN 56296-1740 - Phone
- (320) 563-8124
- Fax
- (320) 563-4133
- NPI assigned
- Jun 20, 2005
- Organization subpart
- No
Authorized official
- Name
- Eric R Lunde
- Title
- Board Member
- Phone
- (612) 695-5618
Member of 1
Practitioners 1
-
Patrick E Emery, MD
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 00669 | MN | Yes |
Addresses
Primary practice location
303 7TH St S
Wheaton, MN 56296-1740
Mailing address
303 7TH St S
Wheaton, MN 56296-1740
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 145240100 | Medicaid | MN | |
| 9264TR | Other | MN | BCBS OF MINNESOTA |
Other names
- Traverse Care Center
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All providers in Wheaton, MN · Skilled Nursing 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 Apr 9, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.