Healthcare Provider Details

I. General information

NPI: 1033260369
Provider Name (Legal Business Name): CFHGROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2007
Last Update Date: 06/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

912 KNOB HILL RD
BURNSVILLE MN
55337-4325
US

IV. Provider business mailing address

17595 260TH ST
SHAFER MN
55074-9629
US

V. Phone/Fax

Practice location:
  • Phone: 952-889-8056
  • Fax:
Mailing address:
  • Phone: 612-257-8146
  • Fax: 651-257-9245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number StateMN

VIII. Authorized Official

Name: MR. ROBERT ROY CARDENAS
Title or Position: CEO
Credential:
Phone: 612-670-1380