MEDICARE: HOUSING & REDEVELOPMENT AUTHORITY OF MORRIS

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	251E00000X	Home Health Agency		MN

General Provider Information

NPI Number	:	1790788891
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOUSING & REDEVELOPMENT AUTHORITY OF MORRIS

Provider Business Mailing Address
First Line	:	100 S COLUMBIA AVE
Second Line	:
City	:	MORRIS
State	:	MN
Zip	:	56267-1540
Country	:	US
Telephone Number	:	320-589-3142
Fax Number	:	320-589-3008

Provider Business Practice Location Address
First Line	:	100 S COLUMBIA AVE
Second Line	:
City	:	MORRIS
State	:	MN
Zip	:	56267-1540
Country	:	US
Telephone Number	:	320-589-3142
Fax Number	:	320-589-3008

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MELANIE A FOHL
Credential	:
Telephone Number	:	320-589-3142

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	08/22/2020

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