Healthcare Provider Details

I. General information

NPI: 1790785194
Provider Name (Legal Business Name): TUFF MEMORIAL HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2005
Last Update Date: 07/21/2025
Certification Date: 07/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 E 4TH ST
HILLS MN
56138-1017
US

IV. Provider business mailing address

505 E 4TH ST
HILLS MN
56138-1017
US

V. Phone/Fax

Practice location:
  • Phone: 507-962-3275
  • Fax: 507-962-3277
Mailing address:
  • Phone: 507-962-3275
  • Fax: 507-962-3277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number328220
License Number StateMN

VIII. Authorized Official

Name: KATIE L KENDALL
Title or Position: ADMINISTRATOR
Credential: LNHA
Phone: 507-962-3275