NPI 1205426939 · live from the CMS NPI Registry
Agate Bay Assisted Living LLC
Skilled Nursing Facility in Two Harbors, MN. National Provider Identifier 1205426939, active.
NPI record
| NPI | 1205426939 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Skilled Nursing Facility 314000000X |
| Practice location | 414 1st Ave, Two Harbors, MN 55616 |
| Practice phone | 218-834-4015 |
| Enumerated | January 26, 2021 |
| Last updated | January 26, 2021 |
| Authorized official | Felisha Johnson, Cfo |
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.