Healthcare Provider Details

I. General information

NPI: 1730186487
Provider Name (Legal Business Name): GOOD NEIGHBOR RESOURCES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14387 EDGEWOOD DR
BAXTER MN
56425-8460
US

IV. Provider business mailing address

PO BOX 481
BRAINERD MN
56401-0481
US

V. Phone/Fax

Practice location:
  • Phone: 218-829-9238
  • Fax: 218-829-2144
Mailing address:
  • Phone: 218-829-9238
  • Fax: 218-829-2144

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateMN

VIII. Authorized Official

Name: DONNA BZDOK
Title or Position: CHIEF FINANCIAL OFFICER
Credential: CPA
Phone: 218-829-9238