OrganizationActive
Mount Olivet Home
NPI 1619976974 · Nursing Facility/Intermediate Care Facility · Minneapolis, MN
Provider details
- NPI number
- 1619976974
- Entity type
- Organization
- Primary specialty
- Nursing Facility/Intermediate Care FacilityNursing & Custodial Care Facilities
- Authorized official
- Richard Anderson, Controller
- License
- 328408 (MN)
Practice location
5517 Lyndale Ave S
Minneapolis, MN 55419-1719
Phone: (612) 827-5677
Fax: (612) 821-3241
Mailing address
5517 Lyndale Ave S
Minneapolis, MN 55419-1719
Registry dates
- Enumerated
- 2005-07-19
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.