MEDICARE: BETHANY COVENANT HOME

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	NO NUMBERS USED	MN

General Provider Information

NPI Number	:	1073618997
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BETHANY COVENANT HOME

Provider Business Mailing Address
First Line	:	2309 HAYES ST NE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55418-3934
Country	:	US
Telephone Number	:	612-781-2691
Fax Number	:	612-781-8835

Provider Business Practice Location Address
First Line	:	2309 HAYES ST NE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55418-3934
Country	:	US
Telephone Number	:	612-781-2691
Fax Number	:	612-781-8835

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. RICK K FISK
Credential	:
Telephone Number	:	773-878-2295

Provider Enumeration Date	:	09/14/2006
Last Update Date	:	08/22/2020

Similar Medicare Providers

1497950380 — CYNTHIA FLETSCHOCK
Practice Location Address:

2309 HAYES ST NE
MINNEAPOLIS, MN
55418-3934

Practice Phone: 612-238-2404
Practice Fax:

1710256201 — SENIOR HEALTH MANAGEMENT, INC.
Practice Location Address:

2309 HAYES ST NE
MINNEAPOLIS, MN
55418-3934

Practice Phone: 612-741-7241
Practice Fax:

1669863106 — BETHANY MN MANAGEMENT, LLC
Practice Location Address:

2309 HAYES ST NE
MINNEAPOLIS, MN
55418-3934

Practice Phone: 612-781-2691
Practice Fax:

1013515345 — PC HAYES MANAGEMENT LLC
Practice Location Address:

2309 HAYES ST NE
MINNEAPOLIS, MN
55418-3934

Practice Phone: 612-781-2691
Practice Fax:

1114903978 — MARY E HANSON PNP
Practice Location Address:

5320 HYLAND GREENS DR
MINNEAPOLIS, MN
55437-3934

Practice Phone: 952-993-2555
Practice Fax:

1265660492 — MS. CYNTHIA DAY
Practice Location Address:

3934 1ST AVE S APT 10
MINNEAPOLIS, MN
55409-1672

Practice Phone: 612-824-4785
Practice Fax:

Directions to “BETHANY COVENANT HOME ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.