Healthcare Provider Details

I. General information

NPI: 1487802450
Provider Name (Legal Business Name): GUIDED TRANSITIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2008
Last Update Date: 05/16/2024
Certification Date: 05/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

905 N BASSWOOD AVE
DULUTH MN
55811-5100
US

IV. Provider business mailing address

PO BOX 236
COTTON MN
55724-0236
US

V. Phone/Fax

Practice location:
  • Phone: 218-249-1144
  • Fax: 218-461-1999
Mailing address:
  • Phone: 218-249-1144
  • Fax: 218-461-1999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number1052308
License Number StateMN

VIII. Authorized Official

Name: MR. MARK F WICKER
Title or Position: PRESIDENT
Credential:
Phone: 218-249-1144