Healthcare Provider Details

I. General information

NPI: 1689090326
Provider Name (Legal Business Name): ST CROIX HOSPICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2014
Last Update Date: 04/14/2021
Certification Date: 04/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 ELKADER ST
STRAWBERRY POINT IA
52076-9423
US

IV. Provider business mailing address

7755 3RD ST N STE 200
OAKDALE MN
55128-5442
US

V. Phone/Fax

Practice location:
  • Phone: 563-933-2090
  • Fax: 563-933-2070
Mailing address:
  • Phone: 651-735-3656
  • Fax: 651-735-0155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. HEATH A BARTNESS
Title or Position: CEO
Credential:
Phone: 651-735-3656