Stonehaven Assisted Living Inc.

Organization Active NPI Assisted Living Facility · Brookston, MN

NPI 1790060838 · NPPES record last updated Oct 20, 2011

Key facts

NPI
1790060838
Entity type
Organization (NPI type 2)
Primary specialty
Assisted Living Facility 310400000X
License
354457 (MN)
Legal business name
STONEHAVEN ASSISTED LIVING INC.
Practice address
8783 2ND Street South
Brookston, MN 55711-0284
Phone
(218) 453-5062
Fax
(218) 453-5064
NPI assigned
Oct 20, 2011
Organization subpart
Yes
Parent organization (as reported)
STONEHAVEN ASSISTED LIVING INC.

Authorized official

Name
Mrs. Jennifer Renee Johnson
Title
President/Owner
Phone
(218) 453-5062

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Part of
Stonehaven Assisted Living Inc

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 354457 MN Yes
Nursing Facility/Intermediate Care Facility 313M00000X 35448 MN

Addresses

Primary practice location

8783 2ND Street South
Brookston, MN 55711-0284

Mailing address

8783 2ND Street South
Brookston, MN 55711-0284
Phone (218) 453-5062

Other providers in Brookston, MN

All providers in Brookston, MN · Assisted Living Facility in Minnesota

Sources for this page

Verify at the official NPI Registry.