NPI: 1417465931 · CALEDONIA, MN 55921 · Assisted Living Facility · NPI assigned 01/18/2018
| Authorized Official | LEDEBUHR, LARRY (CO-OWNER) |
| NPI Enumeration Date | 01/18/2018 |
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 123 | $40K |
| 2023 | 120 | $32K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| T2031 | Assisted living; waiver, per diem | 243 | 24 | $71K |