Healthcare Provider Details

I. General information

NPI: 1891755849
Provider Name (Legal Business Name): BENEDICTINE HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 04/28/2023
Certification Date: 04/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

935 KENWOOD AVE
DULUTH MN
55811-4951
US

IV. Provider business mailing address

935 KENWOOD AVE
DULUTH MN
55811-4951
US

V. Phone/Fax

Practice location:
  • Phone: 218-723-6408
  • Fax: 218-723-6449
Mailing address:
  • Phone: 218-723-6408
  • Fax: 218-723-6449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number329925
License Number StateMN

VIII. Authorized Official

Name: MS. JULIE TOMAINO
Title or Position: BUSINESS OFFICE MANAGER
Credential:
Phone: 218-723-6430