Healthcare Provider Details

I. General information

NPI: 1649752619
Provider Name (Legal Business Name): GENTLE TOUCH HEALTH INITIATIVES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2018
Last Update Date: 09/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 1ST ST NE
BUFFALO MN
55313-1550
US

IV. Provider business mailing address

5000 GLENWOOD AVE
GOLDEN VALLEY MN
55422-5146
US

V. Phone/Fax

Practice location:
  • Phone: 763-682-5489
  • Fax:
Mailing address:
  • Phone: 763-377-1800
  • Fax: 763-377-7291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. LORI ANN MCGUIRE
Title or Position: DIRECTOR OF SENIOR HOUSING
Credential: LPN
Phone: 763-377-1800