Healthcare Provider Details

I. General information

NPI: 1427050582
Provider Name (Legal Business Name): KITTSON MEMORIAL HOSPITAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2005
Last Update Date: 07/03/2025
Certification Date: 07/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 S. BIRCH AVE
HALLOCK MN
56728-4215
US

IV. Provider business mailing address

1010 S BIRCH AVE
HALLOCK MN
56728-4215
US

V. Phone/Fax

Practice location:
  • Phone: 218-843-3662
  • Fax: 218-843-2487
Mailing address:
  • Phone: 218-843-3662
  • Fax: 218-843-2487

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number327220
License Number StateMN

VIII. Authorized Official

Name: ANDREA SWENSON
Title or Position: CEO
Credential:
Phone: 218-843-3612