Provider Demographics
NPI:1962395756
Name:SHELTER ARMS2 LIVING LLC
Entity type:Organization
Organization Name:SHELTER ARMS2 LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL NURSE MANAGER (RN)
Authorized Official - Prefix:
Authorized Official - First Name:ANGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SUMMERVILLE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:952-686-1357
Mailing Address - Street 1:7201 KYLE AVE N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55429-1329
Mailing Address - Country:US
Mailing Address - Phone:952-686-1357
Mailing Address - Fax:763-374-4451
Practice Address - Street 1:7201 KYLE AVE N
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55429-1329
Practice Address - Country:US
Practice Address - Phone:952-686-1357
Practice Address - Fax:763-374-4451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility