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NORTHWOODS DNA INC. NPI 1629338686


NPI Information

NPI: 1629338686
Provider Name: NORTHWOODS DNA, INC.

Doing Business As: BROOKSIDE

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization

CLIA Number: 24D1046874

Address:
2729 STATE 371 SW
PINE RIVER, MN
ZIP 56474
Phone: (218) 587-3304
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NORTHWOODS DNA, INC. is an assisted living facility in Pine River, MN. The provider is 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. NORTHWOODS DNA, INC. NPI is 1629338686. The provider is registered as an organization entity type.
The provider Is Doing Business As Brookside.

The provider's business location address is:

2729 STATE 371 SW
PINE RIVER, MN
ZIP 56474-025
Phone: (218) 587-3304
Fax: (218) 587-3314

The provider's authorized official is Melanie Burns .
The authorized official title is Owner, Administrator and has the following contact phone number (218) 308-4334.

The CLIA number assigned to this NPI record is 24D1046874 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/24/2012 and was last updated on 5/24/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310400000XAssisted Living Facility357493MINNESOTAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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