Provider Demographics
NPI:1619762184
Name:MINNESOTA LAWN CARE
Entity type:Organization
Organization Name:MINNESOTA LAWN CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:OLSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-691-3443
Mailing Address - Street 1:9210 WYOMING AVE N STE 260
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55445-1865
Mailing Address - Country:US
Mailing Address - Phone:763-425-1200
Mailing Address - Fax:
Practice Address - Street 1:9210 WYOMING AVE N STE 260
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55445-1865
Practice Address - Country:US
Practice Address - Phone:763-425-1200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service