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FOUNDATION FOR RURAL HEALTH CARE NPI 1023110350


NPI Information

NPI: 1023110350
Provider Name: FOUNDATION FOR RURAL HEALTH CARE

Doing Business As: EVANSVILLE RESIDENCE

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

CLIA Number: 24D2270020

Address:
651 STATE ST NW
EVANSVILLE, MN
ZIP 56326
Phone: (218) 948-2346
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FOUNDATION FOR RURAL HEALTH CARE is an assisted living facility in Evansville, 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. FOUNDATION FOR RURAL HEALTH CARE NPI is 1023110350. The provider is registered as an organization entity type.
The provider Is Doing Business As Evansville Residence.

The provider's business location address is:

651 STATE ST NW
EVANSVILLE, MN
ZIP 56326-183
Phone: (218) 948-2346

The provider's authorized official is Coral Blaze .
The authorized official title is Ceo and has the following contact phone number (952) 435-7371.

The CLIA number assigned to this NPI record is 24D2270020 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/5/2006 and was last updated on 8/22/2020.


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 Facility333275MINNESOTAYes

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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