Provider Demographics
NPI:1366400822
Name:CURA OF MELROSE LLC
Entity type:Organization
Organization Name:CURA OF MELROSE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:FRED
Authorized Official - Middle Name:
Authorized Official - Last Name:STRUZYK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-249-7364
Mailing Address - Street 1:525 W. MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:MELROSE
Mailing Address - State:MN
Mailing Address - Zip Code:56352
Mailing Address - Country:US
Mailing Address - Phone:320-256-4231
Mailing Address - Fax:320-256-4949
Practice Address - Street 1:525 MAIN ST W
Practice Address - Street 2:
Practice Address - City:MELROSE
Practice Address - State:MN
Practice Address - Zip Code:56352-1043
Practice Address - Country:US
Practice Address - Phone:320-256-4231
Practice Address - Fax:320-256-4949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-03
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN328452314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN04902110Medicaid
MN245396AMedicare ID - Type Unspecified