NPI 1194210997 · live from the CMS NPI Registry
425 N Badger Street Caledonia Opco LLC
Skilled Nursing Facility in Caledonia, MN. National Provider Identifier 1194210997, active.
NPI record
| NPI | 1194210997 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Skilled Nursing Facility 314000000X |
| Practice location | 425 N Badger St, Caledonia, MN 55921 |
| Practice phone | 507-725-3351 |
| Enumerated | June 25, 2018 |
| Last updated | June 29, 2018 |
| Authorized official | Mark Myers, Manager |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Skilled Nursing Facility primary | 314000000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.