Healthcare Provider Details

I. General information

NPI: 1336196633
Provider Name (Legal Business Name): NORTH HOMES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2006
Last Update Date: 07/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1880 RIVER RD
GRAND RAPIDS MN
55744-4085
US

IV. Provider business mailing address

303 SE 1ST ST
GRAND RAPIDS MN
55744-3681
US

V. Phone/Fax

Practice location:
  • Phone: 218-327-3000
  • Fax: 218-327-1871
Mailing address:
  • Phone: 218-327-3000
  • Fax: 218-327-1871

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number1010657-3-CRF
License Number StateMN

VIII. Authorized Official

Name: TRACY LEE FILIPI
Title or Position: BILLING SPECIALIST
Credential:
Phone: 218-751-0282