Colby Lake Care Home, Inc.

LBN: Colby Lake Care Home, Inc.
Colby Lake Care Home, Inc. is an health care organization with primary practice located at 9377 Newcastle Rd , Woodbury MN 55125-3717. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Adult Care Home, which is considered as the primary health care specialty. Colby Lake Care Home, Inc. can be contacted via phone (651) 230-5088, or through Sirju, Vijwantie via phone (651) 230-5088.

Contact Information

Primary practice address
9377 Newcastle Rd Woodbury MN 55125-3717
Phone: (651) 230-5088
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Sirju, Vijwantie Licensed Practical Nurse (LPN)
Phone: (651) 230-5088

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Adult Care Home 311ZA0620X 1047414-2-AFC Minnesota

Profile Details

NPI number 1396980017
LBN Legal business name Colby Lake Care Home, Inc.
DBA Doing business as
Authorized official Sirju, Vijwantie Licensed Practical Nurse (LPN)
Entity Organization
Organization subpart 1 No
Enumeration date Dec 9th, 2008
Last updated Dec 9th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396980017 NPPES
Minnesota MEDICAID A814673100

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