PI
PHS INTERLUDE FRIDLEY LLC
Skilled Nursing Facility
OIG CLEARNPI VERIFIED
Location
FRIDLEY, MN
Licensed since
2014
Rate
—
Federal identifiers
NPI registry number1740697291
Agency details
Medicare activity
StatusNo Medicare utilization on file — neutral.
Authorized official
NameNICOLE DONAHUE
TitleCEO/ADMINISTRATOR
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