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BETHANY BOARD AND LODGE, INC
NPI 1114497773
Assisted Living Facility in Fosston, MN

Active since November 27, 2018
203 S INDERLEE AVE, FOSSTON, MN 56542(218) 435-1044(218) 435-1143 Get Directions Write a Review

NPPES record last updated: November 27, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Bethany Board And Lodge, Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BETHANY BOARD AND LODGE, INC (NPI 1114497773), doing business as Sunrise Customized Living, is a healthcare organization registered as an assisted living facility in Fosston, Minnesota and active in the NPI registry since November 2018. The organization lists Tyler Mcglynn, President, as its authorized official.

NPPES Registry Identity

NPI1114497773
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameBETHANY BOARD AND LODGE, INC
Location Address203 S INDERLEE AVEFosston, MN 56542
Mailing AddressPo Box 28Fosston, MN 56542 · (218) 435-1044 · Fax (218) 435-1143
Phone(218) 435-1044
Fax(218) 435-1143
Organization SubpartNo
Authorized OfficialTyler McglynnPresident · (218) 280-1609
Enumeration DateNovember 27, 2018
✔ NPI 1114497773 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
203 S INDERLEE AVE, Fosston, MN 56542
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Other Names 1

Doing Business AsSunrise Customized Living

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bethany Board And Lodge, Inc's NPI number?

The NPI number for Bethany Board And Lodge, Inc is 1114497773. It was assigned to this organization in the NPPES registry on November 27, 2018. The provider is doing business as Sunrise Customized Living.

Where is Bethany Board And Lodge, Inc located?

Bethany Board And Lodge, Inc is located at 203 S Inderlee Ave, Fosston, MN 56542. The listed phone number is (218) 435-1044.

What is Bethany Board And Lodge, Inc's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

When was this NPI record last updated?

The NPPES record for Bethany Board And Lodge, Inc was last updated on November 27, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.